Provider Demographics
NPI:1184204224
Name:WEST END ADULT DAY HEALTHCARE LLC
Entity Type:Organization
Organization Name:WEST END ADULT DAY HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:STANTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, BA
Authorized Official - Phone:502-510-6406
Mailing Address - Street 1:3847 CANE RUN RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40211-2011
Mailing Address - Country:US
Mailing Address - Phone:502-510-6406
Mailing Address - Fax:
Practice Address - Street 1:3847 CANE RUN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40211-2011
Practice Address - Country:US
Practice Address - Phone:502-510-6406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care