Phoenix Way, Llc

LBN: Phoenix Way, Llc
Phoenix Way, Llc is an health care organization with primary practice located at 4142 Old Columbia Rd , Campbellsville KY 42718-9352. The organization recently has only one registered license in Agencies / Day Training, Developmentally Disabled Services, which is considered as the primary health care specialty. Phoenix Way, Llc can be contacted via phone (270) 283-4352, or through Vaughn, Lucretia Rene via phone (270) 789-9564.

Contact Information

Primary practice address
4142 Old Columbia Rd Campbellsville KY 42718-9352
Phone: (270) 283-4352
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Vaughn, Lucretia Rene
Phone: (270) 789-9564

Health care specialties

SpecialtyCodeLicense #State
Agencies / Day Training, Developmentally Disabled Services 251C00000X Kentucky

Profile Details

NPI number 1114345121
LBN Legal business name Phoenix Way, Llc
DBA Doing business as
Authorized official Vaughn, Lucretia Rene
Entity Organization
Organization subpart 1 No
Enumeration date Apr 7th, 2014
Last updated Dec 2nd, 2014 - about 11 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 1114345121 NPPES
Kentucky MEDICAID 7100282470

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