Provider Demographics
NPI:1164742482
Name:ACCESS ADULT HEALTH DAY CARE CENTER
Entity Type:Organization
Organization Name:ACCESS ADULT HEALTH DAY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMOV
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:502-891-0029
Mailing Address - Street 1:908 DUPONT RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4602
Mailing Address - Country:US
Mailing Address - Phone:502-891-0029
Mailing Address - Fax:502-891-0028
Practice Address - Street 1:908 DUPONT RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4602
Practice Address - Country:US
Practice Address - Phone:502-891-0029
Practice Address - Fax:502-891-0028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-09
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA0600X
KY3676343900000X, 344600000X, 347B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi
No347B00000XTransportation ServicesBus