Organization
HAYATT SUPPORTED COMMUNITY LIVING LLC
Active
Other names
Hayatt Supported Community Living LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BASMA M YAQAH (EXECUTIVE DIRECTOR)
(270) 893-9432
Entity
Organization
Contact information
Practice address
3608 BROOKS CHAPEL RD, DEXTER, KY 42036-9171
(270) 873-9432
Mailing address
3608 BROOKS CHAPEL RD, DEXTER, KY 42036-9171
(270) 873-9432
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/20/2023
Last updated
01/20/2023
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