Provider Demographics
NPI:1588617393
Name:LAUREL SPRINGS, INC.
Entity Type:Organization
Organization Name:LAUREL SPRINGS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-877-6445
Mailing Address - Street 1:PO BOX 226
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-0226
Mailing Address - Country:US
Mailing Address - Phone:606-877-5127
Mailing Address - Fax:606-877-2048
Practice Address - Street 1:51 TWIN PONDS LN
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-9268
Practice Address - Country:US
Practice Address - Phone:606-877-6445
Practice Address - Fax:606-877-6574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY33000100Medicaid