Provider Demographics
NPI:1942072319
Name:GREAT NEIGHBORS LIVING
Entity Type:Organization
Organization Name:GREAT NEIGHBORS LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DASHAWN
Authorized Official - Middle Name:JAMIEL
Authorized Official - Last Name:DAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-487-8038
Mailing Address - Street 1:773 FLORIDA ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-1407
Mailing Address - Country:US
Mailing Address - Phone:704-858-0677
Mailing Address - Fax:
Practice Address - Street 1:773 FLORIDA ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-1407
Practice Address - Country:US
Practice Address - Phone:704-858-0677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health