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Organization
MODERN CARE LLC
Active
Organization
MODERN CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRINA R SANDUSKY RN (MEMBER)
(502) 523-8044
Entity
Organization
Contact information
Practice address
104 NANCY COX DR, SUITE D, CAMPBELLSVILLE, KY 42718-6834
(270) 465-8508
(270) 465-8504
Mailing address
104 NANCY COX DR, SUITE D, CAMPBELLSVILLE, KY 42718-6834
(270) 465-8508
(270) 465-8504
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
—
—
311ZA0620X
Adult Care Home Facility
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100144580
—
KY
Enumeration date
11/23/2010
Last updated
07/18/2016
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