Provider Demographics
NPI:1447880232
Name:INDEPENDENCE CARE OF KENTUCKY AT LOUISVILLE, LLC
Entity type:Organization
Organization Name:INDEPENDENCE CARE OF KENTUCKY AT LOUISVILLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:VIAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-733-1135
Mailing Address - Street 1:517 W SADDLE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:UPPER SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-1138
Mailing Address - Country:US
Mailing Address - Phone:917-733-1135
Mailing Address - Fax:
Practice Address - Street 1:10200 FOREST GREEN BLVD STE 112
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-5167
Practice Address - Country:US
Practice Address - Phone:917-733-1135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-21
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No253Z00000XAgenciesIn Home Supportive Care