| The Home Of The Innocents | |
|
1100 E Market St Louisville KY 40206-1838 | |
| (502) 596-1088 | |
| (502) 596-1449 |
| Full Name | The Home Of The Innocents |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1100 E Market St, Louisville, Kentucky |
| Authorized Official Name and Position | David Mcdonald (CFO) |
| Authorized Official Contact | 5025961039 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Home Of The Innocents 1100 E Market St Louisville KY 40206-1838 Ph: (502) 596-1000 | The Home Of The Innocents 1100 E Market St Louisville KY 40206-1838 Ph: (502) 596-1088 |
| NPI Number | 1003115940 |
|---|---|
| Provider Enumeration Date | 03/17/2011 |
| Last Update Date | 08/03/2023 |
| Certification Date | 08/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003115940 | NPI | - | NPPES |
| 29201183 | Medicaid | KY | |
| 12500989 | Medicaid | KY | |
| 7100126000 | Medicaid | KY | |
| 29101185 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | 740143 (Kentucky) | Secondary |
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