COMMONWEALTH OF KENTUCKY NPI 1689652513

NPI Information

  • NPI: 1689652513
  • Provider Name: COMMONWEALTH OF KENTUCKY
  • Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
  • Entity Type: Organization
  • Doing Business As: MEADOWS
  • CLIA Number: 18D1029331
  • Address: 210 MEADOWS DR
    MT WASHINGTON, KY
    ZIP 40047
  • Phone: (502) 361-2301

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NPI Details

COMMONWEALTH OF KENTUCKY is an intermediate care facility mentally retarded in Mt Washington, KY. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. COMMONWEALTH OF KENTUCKY NPI is 1689652513. The provider is registered as an organization entity type.
The provider Is Doing Business As Meadows.

The provider's business location address is:

210 MEADOWS DR
MT WASHINGTON, KY
ZIP 40047-013
Phone: (502) 361-2301
Fax: (502) 363-6114

The provider's authorized official is Jennifer Moore .
The authorized official title is Assistant Director and has the following contact phone number (502) 782-6117.

The CLIA number assigned to this NPI record is 18D1029331 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/30/2005 and was last updated on 8/7/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1315P00000XIntermediate Care Facility, Intellectual Disabilities100695KENTUCKYYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
111933157MEDICAIDKENTUCKY

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: 3/30/2025

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