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Organization

HOME OF THE INNOCENTS, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LESLIE ANN KAUFMAN (CREDENTIALING/CONTRACT SPECIALIST)
(502) 596-1048
Entity
Organization

Contact information

Practice address
1050 E MARKET ST, LOUISVILLE, KY 40206-1874
(502) 596-1090
(502) 596-1410
Mailing address
1050 E MARKET ST, LOUISVILLE, KY 40206-1874
(502) 596-1090
(502) 596-1410

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
261QM2500X
Medical Specialty Clinic/Center
740143
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
12500989
KY
05
29101185
KY
05
29201183
KY
05
7100126000
KY
Enumeration date
09/20/2010
Last updated
05/15/2025
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