Provider Demographics
NPI:1326192345
Name:OPTIONS FOR INDIVIDUALS, INC
Entity Type:Organization
Organization Name:OPTIONS FOR INDIVIDUALS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:CGW,MBA-HCM
Authorized Official - Phone:502-493-0007
Mailing Address - Street 1:2200 ENVOY CIR
Mailing Address - Street 2:SUITE 2201
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-1827
Mailing Address - Country:US
Mailing Address - Phone:502-493-0007
Mailing Address - Fax:502-493-0021
Practice Address - Street 1:2200 ENVOY CIR
Practice Address - Street 2:SUITE 2201
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-1827
Practice Address - Country:US
Practice Address - Phone:502-493-0007
Practice Address - Fax:502-493-0021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33900143251C00000X
KY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY33900143Medicaid