Organization
THE PRINCECARE GROUP
Active
Organization
THE PRINCECARE GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIM DEWAYNE HISLE (PRESIDENT)
(502) 428-9037
Entity
Organization
Contact information
Practice address
1520 BAXTER AVE, LOUISVILLE, KY 40205
(502) 896-8147
(502) 896-8149
Mailing address
1520 BAXTER AVE, LOUISVILLE, KY 40205-1009
(502) 896-8147
(502) 896-8149
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
261Q00000X
Clinic/Center
—
—
261QA0600X
Adult Day Care Clinic/Center
7100233390
KY
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
7100199960
KY
261QR0400X
Rehabilitation Clinic/Center
—
KY
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
7100010990
KY
Other
Enumeration date
04/20/2007
Last updated
07/12/2018
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up