Organization
CEDAR LAKE RESIDENCES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE CAROL KERSTING (ASSISTANT CONTROLLER)
(502) 327-7706
Entity
Organization
Contact information
Practice address
7984 NEW LAGRANGE RD, LOUISVILLE, KY 40222-4718
(502) 327-7706
(502) 327-7417
Mailing address
7984 NEW LAGRANGE RD, LOUISVILLE, KY 40222-4718
(502) 327-7706
(502) 327-7417
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43000900
—
KY
Enumeration date
06/01/2007
Last updated
08/22/2020
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