Provider Demographics
NPI:1346558749
Name:CASCADES COMMUNITY LIVING LLC
Entity Type:Organization
Organization Name:CASCADES COMMUNITY LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:K
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-352-2555
Mailing Address - Street 1:1604 LOUISVILLE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-3919
Mailing Address - Country:US
Mailing Address - Phone:502-352-2555
Mailing Address - Fax:502-352-2556
Practice Address - Street 1:1604 LOUISVILLE RD
Practice Address - Street 2:SUITE A
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-3919
Practice Address - Country:US
Practice Address - Phone:502-352-2555
Practice Address - Fax:502-352-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health