Provider Demographics
NPI:1972519395
Name:SAFEWORKS HEALTHCARE
Entity Type:Organization
Organization Name:SAFEWORKS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DEYOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-245-0767
Mailing Address - Street 1:13100 EASTPOINT PARK BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-3157
Mailing Address - Country:US
Mailing Address - Phone:502-245-0767
Mailing Address - Fax:502-245-1380
Practice Address - Street 1:13100 EASTPOINT PARK BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-3157
Practice Address - Country:US
Practice Address - Phone:502-245-0767
Practice Address - Fax:502-245-1380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR1714225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7606Medicare ID - Type UnspecifiedMEDICARE NUMBER