Organization
CEDAR LAKE REHABILITATION SERVICES
Active
Parent organization
CEDAR LAKE RESIDENCES
Organization subpart
Yes
Provider details
NPI number
Legal business name
CEDAR LAKE RESIDENCES
Authorized official
MRS. MICHELLE C KERSTING (DIRECTOR OF FINANCIAL SERVICES)
(502) 327-7706
Entity
Organization
Contact information
Practice address
9505 WILLIAMSBURG PLZ, SUITE 200, LOUISVILLE, KY 40222-5082
(502) 327-7706
Mailing address
9505 WILLIAMSBURG PLZ, SUITE 200, LOUISVILLE, KY 40222-5082
(502) 327-7706
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
100934
KY
261QP2000X
Physical Therapy Clinic/Center
Primary
100934
KY
261QX0100X
Occupational Medicine Clinic/Center
100934
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33900572
—
KY
Enumeration date
06/05/2015
Last updated
06/05/2015
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