Cedar Lake Residences, Inc.

LBN: Cedar Lake Residences, Inc.
Cedar Lake Residences, Inc. is an health care organization with primary practice located at 9505 Williamsburg Plz Suite 200, Louisville KY 40222-5082. The organization recently has 3 registered licenses in different health care specialties including Agencies / Case Management, Agencies / Day Training, Developmentally Disabled Services, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Agencies / Day Training, Developmentally Disabled Services is the primary health care specialty. Cedar Lake Residences, Inc. can be contacted via phone (502) 327-7706, or through Grimes, Courtney E via phone (502) 265-8389.

Contact Information

Primary practice address
9505 Williamsburg Plz Suite 200 Louisville KY 40222-5082
Phone: (502) 327-7706
Fax: (502) 425-3540
Website:
Map and Directions
Authorized official contact:
Name: Grimes, Courtney E
Phone: (502) 265-8389

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X 100934 Kentucky
Agencies / Day Training, Developmentally Disabled Services 251C00000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X

Profile Details

NPI number 1447396049
LBN Legal business name Cedar Lake Residences, Inc.
DBA Doing business as
Authorized official Grimes, Courtney E
Entity Organization
Organization subpart 1 No
Enumeration date Jan 30th, 2007
Last updated Oct 19th, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447396049 NPPES
Kentucky MEDICAID 33900572

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