Cedar Lake Lodge/Sycamore Run
LBN: Cedar Lake Lodge/Sycamore Run
Cedar Lake Lodge/Sycamore Run is an health care organization with primary practice located at 9505 Williamsburg Plz Ste 200, Louisville KY 40222-5082. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Intermediate Care Facility, Mental Illness, Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded. Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded is the primary health care specialty.
Cedar Lake Lodge/Sycamore Run can be contacted via phone (502) 495-4953, or through Grimes, Courtney Elaine via phone (502) 495-4953.
Contact Information
Primary practice address
9505 Williamsburg Plz Ste 200
Louisville KY 40222-5082
Phone: (502) 495-4953
Fax: (502) 425-3540
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Intermediate Care Facility, Mental Illness | 310500000X | 101246 | Kentucky |
| Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded | 315P00000X | 101247 | Kentucky |
Profile Details
| NPI number | 1790232577 |
|---|---|
| LBN Legal business name | Cedar Lake Lodge/Sycamore Run |
| DBA Doing business as | |
| Authorized official | Grimes, Courtney Elaine |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 8th, 2016 |
| Last updated | Jan 31st, 2022 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790232577 | NPPES |
| Kentucky | MEDICAID | 101246 | |
| Kentucky | MEDICAID | 101247 |
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