Organization
LINCOLN TRAIL AREA DEVELOPMENT DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL LONDON (EXECUTIVE DIRECTOR)
(270) 769-2393
Entity
Organization
Contact information
Practice address
750 S PROVIDENT WAY, ELIZABETHTOWN, KY 42701-5956
(270) 769-2393
(270) 769-2993
Mailing address
750 S PROVIDENT WAY, ELIZABETHTOWN, KY 42701-5956
(270) 769-2393
(270) 769-2993
Taxonomy
Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43996057
HCB WAIVER
KY
Enumeration date
01/25/2007
Last updated
07/19/2024
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