Organization
COMMUNITY LIFE CONNECTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHERINE ELIZABETH STACKS (OWNER)
(270) 320-4868
Entity
Organization
Contact information
Practice address
253 FARMER LN, BOWLING GREEN, KY 42104-8544
(270) 320-4868
Mailing address
253 FARMER LN, BOWLING GREEN, KY 42104-8544
(270) 320-4868
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
KY
253Z00000X
In Home Supportive Care Agency
Primary
—
KY
Other
Enumeration date
12/30/2015
Last updated
07/21/2022
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