Provider Demographics
NPI:1356056055
Name:CENTER FOR ACCESSIBLE LIVING
Entity type:Organization
Organization Name:CENTER FOR ACCESSIBLE LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:RAYE
Authorized Official - Last Name:MOBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:502-589-6620
Mailing Address - Street 1:501 S 2ND ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1864
Mailing Address - Country:US
Mailing Address - Phone:502-589-6620
Mailing Address - Fax:502-589-3980
Practice Address - Street 1:501 S 2ND ST STE 200
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1864
Practice Address - Country:US
Practice Address - Phone:502-589-6620
Practice Address - Fax:502-589-3980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management