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Organization

NEW AGE ADULT DAY SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MONIQUE LISA LAVERTU-KOTTCAMP (DIRECTOR)
(270) 422-7777
Entity
Organization

Contact information

Practice address
2015 BYPASS RD, BRANDENBURG, KY 40108-1605
(270) 422-7777
(270) 422-7799
Mailing address
2015 BYPASS RD, BRANDENBURG, KY 40108-1605
(270) 422-7777
(270) 422-7799

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43000348
KY
Enumeration date
01/24/2007
Last updated
08/22/2020
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