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Organization

LINCOLN WAY LLC JANICE DIANE HAYCRAFT SINGLE MBR

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JANICE DIANE HAYCRAFT (OWNER)
(270) 358-6088
Entity
Organization

Contact information

Practice address
103 LINCOLN DR, HODGENVILLE, KY 42748-9780
(270) 358-6088
(270) 358-6089
Mailing address
103 LINCOLN DR, HODGENVILLE, KY 42748-9780
(270) 358-6088
(270) 358-6089

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
33001587
KY
Enumeration date
02/14/2008
Last updated
09/30/2014
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