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General NPI Number Information
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NPI Number | 1972603843
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Entity Type | Organization
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Legal Business Name | HOME FOR THE AGED OF THE LITTLE SISTERS OF THE POOR, INC
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 07/25/2016
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Provider Practice Location Address
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Address Line | 15 AUDUBON PLAZA DRIVE
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City | LOUISVILLE
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State | KY
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Zip | 40217-1318
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Country | US
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Telephone | 502-636-2300
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Fax | 502-634-0737
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Provider Business Mailing Address
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Address Line | 15 AUDUBON PLAZA DRIVE
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City | LOUISVILLE
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State | KY
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Zip | 40217-1318
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Country | US
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Telephone | 502-636-2300
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Fax | 502-634-0737
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MAUREEN COURTNEY
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Credential |
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Telephone | 502-636-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 100641
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License Number State | KY
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