Organization
ALTERNATIVE ADULT DAY HEALTH CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LEAH JANE FERGUSON ADMINISTRATOR (ADMINISTRATOR)
(502) 955-1750
Entity
Organization
Contact information
Practice address
147 WILMA AVE, LOUISVILLE, KY 40229-6623
(502) 955-1750
(502) 955-9010
Mailing address
147 WILMA AVE, LOUISVILLE, KY 40229-6623
(502) 955-1750
(502) 955-9010
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
261QH0100X
Health Service Clinic/Center
7100170430
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43000009
—
KY
Enumeration date
02/07/2007
Last updated
02/17/2014
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