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General NPI Number Information
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NPI Number | 1992958250
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Entity Type | Organization
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Legal Business Name | CARETENDERS VS OF LINCOLN TRAIL LLC
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Dates
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Enumeration Date | 10/30/2008
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 1105 JULIANNA CT SUITE 3
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-7937
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Country | US
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Telephone | 270-234-2273
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Fax | 270-234-1807
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Provider Business Mailing Address
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Address Line | PO BOX 51266
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City | LAFAYETTE
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State | LA
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Zip | 70505-1266
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Country | US
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Telephone | 337-233-1307
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Fax | 337-443-4154
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOSHUA PROFFITT
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Credential |
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Telephone | 337-233-1307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management 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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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