Organization
COMMONWEALTH OF KENTUCKY
Active
Parent organization
COMMONWEALTH OF KENTUCKY
Other names
Meadows
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMONWEALTH OF KENTUCKY
Authorized official
JENNIFER MOORE (ASSISTANT DIRECTOR)
(502) 782-6117
Entity
Organization
Contact information
Practice address
210 MEADOWS DR, MT WASHINGTON, KY 40047-6013
(502) 361-2301
(502) 363-6114
Mailing address
210 MEADOWS DR, MT WASHINGTON, KY 40047-6013
(502) 361-2301
(502) 363-6114
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
100695
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11933157
—
KY
Enumeration date
12/30/2005
Last updated
08/07/2024
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