MEDICARE: CARETENDERS VS OF CENTRAL KY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	251J00000X	Nursing Care Agency
3	252Y00000X	Early Intervention Provider Agency
4	253Z00000X	In Home Supportive Care Agency
5	3747P1801X	Personal Care Attendant
6	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1295980043
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARETENDERS VS OF CENTRAL KY, LLC

Provider Business Mailing Address
First Line	:	PO BOX 51266
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70505-1266
Country	:	US
Telephone Number	:	337-233-1307
Fax Number	:	337-443-4154

Provider Business Practice Location Address
First Line	:	1717 DIXIE HWY
Second Line	:	SUITE 240
City	:	FT WRIGHT
State	:	KY
Zip	:	41011-2766
Country	:	US
Telephone Number	:	859-578-0022
Fax Number	:	859-441-6380

Authorized Official
Title or Position	:	EXECUTIVE VICE PRESIDENT
Name	:	MR. JOSHUA PROFFITT
Credential	:
Telephone Number	:	337-233-1307

Provider Enumeration Date	:	11/20/2008
Last Update Date	:	09/16/2024

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