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Cedar Lake Lodge/sycamore Run
Intellectual Disabilities Intermediate Care Facility in Louisville, Kentucky
NPI 1790232577

Cedar Lake Lodge/sycamore Run is a Intellectual Disabilities Intermediate Care Facility based in Louisville, KY. Cedar Lake Lodge/sycamore Run practices in Louisville, KY. The NPI Number for Cedar Lake Lodge/sycamore Run is 1790232577 and holds a License No. 101246 (Kentucky).

The current practice location address for Cedar Lake Lodge/sycamore Run is 9505 Williamsburg Plz, Louisville, KY and can be reached out via phone at 502-495-4953 and via fax at 502-425-3540.

Location: 9505 Williamsburg Plz, Louisville, KY, 40222-5082
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1790232577
Provider Name
Cedar Lake Lodge/sycamore Run
Credential
Provider Entity Type
Organization
Address
9505 Williamsburg Plz, Louisville, KY, 40222-5082
Phone Number
502-495-4953
Fax Number
502-425-3540
Provider Enumeration Date
09/08/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
101246 05 KY
101247 05 KY
institution
Provider Business Practice Location Address Details
Address
9505 Williamsburg Plz
City
Louisville
State
Kentucky
Zip
40222-5082
Phone Number
502-495-4953
Fax Number
502-425-3540
person
Provider Business Mailing Address Details
Address
9505 Williamsburg Plz
City
Louisville
State
Kentucky
Zip
40222-5082
Phone Number
502-495-4953
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.
101247 (Kentucky)
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
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
101246 (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.
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Similar Doctors in Louisville, Kentucky:

institution
Cedar Lake Lodge, Inc.
NPI 1568508190
Intellectual Disabilities Intermediate Care Facility
9505 Williamsburg Plz Ste 200,
LOUISVILLE, KY
40222-5089
502-265-8389
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