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NPI Code Detail

MEDICARE: KENTUCKYIANA COMMUNITY BASED SERVICES

MEDICARE: KENTUCKYIANA COMMUNITY BASED SERVICES
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor
2251B00000XCase Management Agency
3251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1528914504
Entity Type Code : Organization
Provider Name (Legal Business Name) : KENTUCKYIANA COMMUNITY BASED SERVICES
Provider Business Mailing Address
First Line : 4452 DIXIE HWY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40216-2866
Country : US
Telephone Number : 502-314-1632
Fax Number : 502-888-2178
Provider Business Practice Location Address
First Line : 4452 DIXIE HWY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40216-2866
Country : US
Telephone Number : 502-536-3545
Fax Number : 502-888-2178
Authorized Official
Title or Position : CEO
Name : JAMES A TAYLOR
Credential : LPCC
Telephone Number : 502-314-1632
Provider Enumeration Date : 03/10/2026
Last Update Date : 03/10/2026

Similar Medicare Providers

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1164583043 — DR. KENNETH GREGORY PUGH M.D.
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1518283993 — AMBICA MANJUNATH TUMKUR MD
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Directions to “KENTUCKYIANA COMMUNITY BASED SERVICES ” Practice Location

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