Organization
SALEM VILLAGES MRDD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEENA OMBRES (PRIVACY OFFICER)
(502) 394-2387
Entity
Organization
Contact information
Practice address
247 PLAZA OVAL, CASSELBERRY, FL 32707-2934
(352) 372-0130
Mailing address
10140 LINN STATION RD, LOUISVILLE, KY 40223-3813
(800) 866-0860
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028057700
—
FL
Enumeration date
12/01/2006
Last updated
12/02/2010
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