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MODERN CARE LLC NPI 1659673655


NPI Information

NPI: 1659673655
Provider Name: MODERN CARE LLC
Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

Address:
104 NANCY COX DR
SUITE D
CAMPBELLSVILLE, KY
ZIP 42718
Phone: (270) 465-8508
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MODERN CARE LLC is an adult care home custodial care facility in Campbellsville, KY. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. MODERN CARE LLC NPI is 1659673655. The provider is registered as an organization entity type.

The provider's business location address is:

104 NANCY COX DR
SUITE D
CAMPBELLSVILLE, KY
ZIP 42718-834
Phone: (270) 465-8508
Fax: (270) 465-8504

The provider's authorized official is Trina R Sandusky .
The authorized official title is Member and has the following contact phone number (502) 523-8044.

The enumeration date for this NPI number is 11/23/2010 and was last updated on 7/18/2016.


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
1311Z00000XCustodial Care FacilityNo
2311ZA0620XCustodial Care FacilityAdult Care HomeKENTUCKYYes

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
17100144580MEDICAIDKENTUCKY

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

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