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Organization

PERSONAL CARE AGENCY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHAVONDA HILL (OWNER)
(502) 416-2988
Entity
Organization

Contact information

Practice address
2305 GRAND AVE, LOUISVILLE, KY 40210-1145
(502) 777-9201
Mailing address
2305 GRAND AVE, LOUISVILLE, KY 40210-1145
(502) 416-2988

Taxonomy

Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
343900000X
Non-emergency Medical Transport (VAN)

Other

Enumeration date
06/07/2023
Last updated
06/07/2023
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