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General NPI Number Information
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NPI Number | 1942814868
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Entity Type | Organization
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Legal Business Name | RENAISSANCE SHELBYVILLE PARTNERS 1, LLC
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Dates
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Enumeration Date | 09/08/2020
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Last Update Date | 09/08/2020
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Provider Practice Location Address
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Address Line | 156 HAVEN HILL RD
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City | SHELBYVILLE
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State | KY
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Zip | 40065-8752
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Country | US
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Telephone | 502-647-4546
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Fax | 502-647-4554
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Provider Business Mailing Address
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Address Line | 12933 W HIGHWAY 42
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City | PROSPECT
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State | KY
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Zip | 40059-9107
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Country | US
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Telephone | 502-228-8131
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Fax | 502-228-1940
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Authorized Official
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Title or Position | OWNER/MANAGEMENT AGENT
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Name | KATHY BELLANDE
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Credential |
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Telephone | 502-228-8131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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