Organization
RANDOM HOUSE COMMUNITY LIVING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY ALLEN BOMAR (EXECUTIVE DIRECTOR)
(502) 239-7799
Entity
Organization
Contact information
Practice address
5505 RANDOM WAY, LOUISVILLE, KY 40291-1821
(502) 239-7799
Mailing address
373 WHITFIELD LN, TAYLORSVILLE, KY 40071-6300
(502) 239-7799
(502) 239-2809
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/03/2008
Last updated
03/03/2008
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