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Organization
VICARE
Active
Organization
VICARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR JOSEPH DIORIO III (PRESIDENT)
(502) 384-1840
Entity
Organization
Contact information
Practice address
4119 BROWNS LN, BUILDING 3, LOUISVILLE, KY 40220-1500
(502) 384-1840
(502) 384-1840
Mailing address
4119 BROWNS LN, BUILDING 3, LOUISVILLE, KY 40220-1500
(502) 384-1840
(502) 384-1840
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NULL
251C00000X
Developmentally Disabled Services Day Training Agency
—
NULL
261QD1600X
Developmental Disabilities Clinic/Center
—
NULL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NULL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
NULL
Other
Enumeration date
11/16/2006
Last updated
04/29/2008
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