Organization
SOUTHSIDE PERSONAL CARE HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDIRASHID AHMED KANYARE (MANAGER)
(502) 533-1492
Entity
Organization
Contact information
Practice address
5330 S 3RD ST, LOUISVILLE, KY 40214-2680
(502) 533-1492
(502) 212-9292
Mailing address
5330 S 3RD ST, LOUISVILLE, KY 40214-2680
(502) 533-1492
(502) 212-9292
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500334
CABINET FOR HEALTH AND FAMILY SERVICES OFFICE OF INSPECTOR GENERAL
KY
Enumeration date
05/21/2020
Last updated
08/07/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us