Organization
LORD'S LEGACY LIFE MINISTRIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANENE MADER (PRESIDENT)
(859) 881-1262
Entity
Organization
Contact information
Practice address
205 KEVIN DR, NICHOLASVILLE, KY 40356-1282
(859) 881-1262
(859) 881-1268
Mailing address
205 KEVIN DR, NICHOLASVILLE, KY 40356-1282
(859) 881-1262
(859) 881-1268
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33001546
—
KY
Enumeration date
03/14/2007
Last updated
08/22/2020
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