Basic Information
Provider Information
NPI: 1578734695
EntityType: 2
ReplacementNPI:  
OrganizationName: RES-CARE, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: OUTWOOD GROUP HOME - CAKY
OtherOrganizationType: 5
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9901 LINN STATION RD
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402233808
CountryCode: US
TelephoneNumber: 5023942387
FaxNumber:  
Practice Location
Address1: 23524 DAWSON SPRINGS RD
Address2:  
City: DAWSON SPRINGS
State: KY
PostalCode: 424089205
CountryCode: US
TelephoneNumber: 2707973771
FaxNumber: 2707973592
Other Information
ProviderEnumerationDate: 03/17/2008
LastUpdateDate: 06/17/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: OMBRES
AuthorizedOfficialFirstName: DEENA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRIVACY OFFICER
AuthorizedOfficialTelephone: 5023942387
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
315P00000X KYY Nursing & Custodial Care FacilitiesIntermediate Care Facility, Mentally Retarded 

No ID Information.


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