Individual
LISA G TESCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
237 GLENDORA AVE, LOUISVILLE, KY 40212-2529
(502) 579-0153
Mailing address
PO BOX 9292, LOUISVILLE, KY 40209-0292
(502) 579-0153
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
KY
253Z00000X
In Home Supportive Care Agency
—
KY
347E00000X
Transportation Broker
—
KY
3747A0650X
Attendant Care Provider
Primary
—
—
376J00000X
Homemaker
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120452493
—
KY
Enumeration date
02/21/2023
Last updated
02/24/2023
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