Organization
SENIOR HAVEN PERSONAL CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIAJIAH PHILIDOR RN (PRESIDENT)
(502) 616-0376
Entity
Organization
Contact information
Practice address
1432 AVOCA RIDGE DR, LOUISVILLE, KY 40223-3289
(502) 510-9916
Mailing address
1432 AVOCA RIDGE DR, LOUISVILLE, KY 40223-3289
(502) 510-9916
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Enumeration date
03/17/2025
Last updated
03/17/2025
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