Provider Demographics
NPI:1114064169
Name:KENTUCKY EASTER SEAL SOCIETY, INC.
Entity Type:Organization
Organization Name:KENTUCKY EASTER SEAL SOCIETY, INC.
Other - Org Name:CARDINAL HILL REHABILITATION HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNTING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:A
Authorized Official - Last Name:DELLECHIAIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-246-8814
Mailing Address - Street 1:2050 VERSAILLES ROAD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504
Mailing Address - Country:US
Mailing Address - Phone:859-367-7217
Mailing Address - Fax:859-367-7155
Practice Address - Street 1:2050 VERSAILLES ROAD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504
Practice Address - Country:US
Practice Address - Phone:859-367-7217
Practice Address - Fax:859-367-7155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY750093261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY43004340Medicaid