1780639690 NPI number — HOME OF THE INNOCENTS

Table of content: (NPI 1780639690)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780639690 NPI number — HOME OF THE INNOCENTS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOME OF THE INNOCENTS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780639690
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/02/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1100 E MARKET ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40206
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-596-1000
Provider Business Mailing Address Fax Number:
502-596-1413

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 E MARKET ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-596-1000
Provider Business Practice Location Address Fax Number:
502-596-1413
Provider Enumeration Date:
05/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCDONALD
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCE OFFICIER
Authorized Official Telephone Number:
502-596-1039

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , with the licence number: 740143 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225100000X , with the licence number: 101130 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X , with the licence number: 101130 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X , with the licence number: 740143 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0400X , with the licence number: 101130 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3140N1450X , with the licence number: 100493 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7100305090 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100268020 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 12500989 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100281540 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100392050 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 201015150A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 65902470 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100156180 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100173100 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100229960 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100275730 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100315940 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 300031860 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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