Provider Type Icon

CEDAR LAKE RESIDENCES INC. NPI 1447396049


NPI Information

NPI: 1447396049
Provider Name: CEDAR LAKE RESIDENCES, INC.
Classification: Day Training, Developmentally Disabled Services - 251C00000X
Entity Type: Organization
Address:
9505 WILLIAMSBURG PLZ
SUITE 200
LOUISVILLE, KY
ZIP 40222
Phone: (502) 327-7706
Get Directions

CEDAR LAKE RESIDENCES, INC. is a day training developmentally disabled services in Louisville, KY. The provider is these agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. CEDAR LAKE RESIDENCES, INC. NPI is 1447396049. The provider is registered as an organization entity type.

The provider's business location address is:

9505 WILLIAMSBURG PLZ
SUITE 200
LOUISVILLE, KY
ZIP 40222-082
Phone: (502) 327-7706
Fax: (502) 425-3540

The provider's authorized official is Courtney E Grimes .
The authorized official title is Program Billing & Reimb Spvsr and has the following contact phone number (502) 265-8389.

The enumeration date for this NPI number is 1/30/2007 and was last updated on 10/19/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251B00000XCase Management100934KENTUCKYNo
2363L00000XNurse PractitionerNo
3251C00000XDay Training, Developmentally Disabled ServicesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
133900572MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.