Organization
KYPPEC,INC
Active
Other names
The Kidz Club
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEE B ZIMMERMAN (PRES)
(502) 210-5538
Entity
Organization
Contact information
Practice address
1101 HERR LN, LOUISVILLE, KY 40222-4301
(502) 210-5538
(502) 327-5098
Mailing address
1101 HERR LN, LOUISVILLE, KY 40222-4301
(502) 210-5538
(502) 327-5098
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
760001
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45000098
—
KY
01
—
50000542
KY PASSPORT PROVIDER NUMB
KY
Enumeration date
02/22/2007
Last updated
01/20/2015
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