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Organization

SENIOR COMMUNITY CARE OF KENTUCKY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NANCY GAVIN (ASSISTANT SECRETARY/ASSISTANT TREAS)
(952) 983-3429
Entity
Organization

Contact information

Practice address
960 S 4TH ST, LOUISVILLE, KY 40203-3252
(502) 676-7550
(502) 676-7516
Mailing address
7530 MARKET PLACE DR, EDEN PRAIRIE, MN 55344-3636
(952) 941-0300
(952) 941-0428

Taxonomy

Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary

Other

Enumeration date
01/24/2023
Last updated
01/24/2023
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