Organization
HICKS ENTERPRISES
Active
Other names
Hicks Enterprises
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH A HICKS (PRESIDENT)
(502) 644-0116
Entity
Organization
Contact information
Practice address
5009 REX LN, LOUISVILLE, KY 40218-4331
(502) 644-0116
Mailing address
2201 LIVERPOOL LN, LOUISVILLE, KY 40218-2201
(502) 644-0116
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/15/2022
Last updated
09/15/2022
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