Organization
CARETENDERS VS OF LINCOLN TRAIL LLC
Active
Other names
Caretenders
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA PROFFITT (PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
1105 JULIANNA CT, SUITE 3, ELIZABETHTOWN, KY 42701-7937
(270) 234-2273
(270) 234-1807
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 443-4154
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100115620
—
KY
01
—
7100115630
MEDICAID WAIVER
KY
Enumeration date
10/30/2008
Last updated
09/16/2024
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