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THE KIDZ CLUB- ST PETELLC NPI 1356687222


NPI Information

NPI: 1356687222
Provider Name: THE KIDZ CLUB- ST PETE,LLC

Doing Business As: THE KIDZ CLUB

Classification: Skilled Nursing Facility - 3140N1450X
Entity Type: Organization

Specialization: Nursing Care, Pediatric

Address:
1101 HERR LN
LOUISVILLE, KY
ZIP 40222
Phone: (502) 210-5538
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THE KIDZ CLUB- ST PETE,LLC is a nursing care and pediatric skilled nursing facility in Louisville, KY. The provider is a nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment. THE KIDZ CLUB- ST PETE,LLC NPI is 1356687222. The provider is registered as an organization entity type.
The provider Is Doing Business As The Kidz Club.

The provider's business location address is:

1101 HERR LN
LOUISVILLE, KY
ZIP 40222-301
Phone: (502) 210-5538
Fax: (502) 327-5098

The provider's authorized official is Debbie A Hunt .
The authorized official title is Vp Of Operations and has the following contact phone number (502) 458-5433.

The enumeration date for this NPI number is 12/21/2012 and was last updated on 12/21/2012.


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
13140N1450XSkilled Nursing FacilityNursing Care, Pediatric2929960060FLORIDAYes

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
1003967601MEDICAIDFLORIDA

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: 11/14/2023

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