Provider Demographics
NPI:1336773753
Name:ARCADIA OF PADUCAH LLC
Entity Type:Organization
Organization Name:ARCADIA OF PADUCAH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:VETTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-357-7035
Mailing Address - Street 1:4360 BROWNSBORO RD STE 305
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-1642
Mailing Address - Country:US
Mailing Address - Phone:502-357-7035
Mailing Address - Fax:
Practice Address - Street 1:2265 OLIVET CHURCH RD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-9769
Practice Address - Country:US
Practice Address - Phone:270-448-7777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility