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General NPI Number Information
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NPI Number | 1881352912
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Entity Type | Organization
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Legal Business Name | DEANNAS ADULT DAY CENTER
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Dates
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Enumeration Date | 12/06/2021
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Last Update Date | 03/24/2022
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Provider Practice Location Address
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Address Line | 6503 DIXIE HWY
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City | LOUISVILLE
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State | KY
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Zip | 40258-3907
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Country | US
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Telephone | 502-445-2808
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Fax |
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Provider Business Mailing Address
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Address Line | 6503 DIXIE HWY
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City | LOUISVILLE
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State | KY
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Zip | 40258-3907
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Country | US
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Telephone | 502-445-2808
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. SHEENA L IVORY
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Credential |
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Telephone | 502-445-2808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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