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Cedar Lake Lodge, Inc.
Child Intellectual and/or Developmental Disabilities Respite Care in Louisville, Kentucky
NPI 1568508190

Cedar Lake Lodge, Inc. is a Child Intellectual and/or Developmental Disabilities Respite Care based in Louisville, KY and is specialized in Respite Care, Intellectual and/or Developmental Disabilities, Child. Cedar Lake Lodge, Inc. practices in Louisville, KY. The NPI Number for Cedar Lake Lodge, Inc. is 1568508190 and holds a License No. 101120 (Kentucky).

The current practice location address for Cedar Lake Lodge, Inc. is 9505 Williamsburg Plz Ste 200, Louisville, KY and can be reached out via phone at 502-265-8389 and via fax at 502-425-3540.

Location: 9505 Williamsburg Plz Ste 200, Louisville, KY, 40222-5089
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1568508190
Provider Name
Cedar Lake Lodge, Inc.
Credential
Provider Entity Type
Organization
Address
9505 Williamsburg Plz Ste 200, Louisville, KY, 40222-5089
Phone Number
502-265-8389
Fax Number
502-425-3540
Provider Enumeration Date
01/30/2007
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
43000512 05 KY
11906153 05 KY
33200353 05 KY
institution
Provider Business Practice Location Address Details
Address
9505 Williamsburg Plz Ste 200
City
Louisville
State
Kentucky
Zip
40222-5089
Phone Number
502-265-8389
Fax Number
502-425-3540
person
Provider Business Mailing Address Details
Address
9505 Williamsburg Plz Ste 200
City
Louisville
State
Kentucky
Zip
40222-5089
Phone Number
502-265-8389
Fax Number
502-425-3540
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mental Illness
Speciality
-
Taxonomy
310500000X
License No.
()
Definition
A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness.
person
Provider's Taxonomy Details 2
Type
Nursing & Custodial Care Facilities
Classification
Nursing Facility/Intermediate Care Facility
Speciality
-
Taxonomy
313M00000X
License No.
()
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
person
Provider's Taxonomy Details 3
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
100450 (Kentucky)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
person
Provider's Taxonomy Details 4
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
101119 (Kentucky)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
person
Provider's Taxonomy Details 5
Type
Respite Care Facility
Classification
Respite Care
Speciality
Respite Care, Intellectual and/or Developmental Disabilities, Child
Taxonomy
385HR2060X
License No.
101120 (Kentucky)
Definition
A facility or distinct part of a facility that provides short term, residential care to children diagnosed with intellectual and/or developmental disabilities as respite for the regular caregivers.
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