Provider Demographics
NPI:1497123392
Name:CAREGIVER SERVICES OF KY LLC
Entity Type:Organization
Organization Name:CAREGIVER SERVICES OF KY LLC
Other - Org Name:PREMIER CAREGIVER SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AGENCY/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:OCALLAGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-384-1840
Mailing Address - Street 1:4640 CHAMBERLAIN LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-1160
Mailing Address - Country:US
Mailing Address - Phone:502-384-1840
Mailing Address - Fax:502-371-0661
Practice Address - Street 1:4640 CHAMBERLAIN LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-1160
Practice Address - Country:US
Practice Address - Phone:502-384-1840
Practice Address - Fax:502-371-0661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY500066253Z00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY500066OtherCOMMONWEALTH OF KY CABINET FOR HEALTH AND FAMILY SERVICES