Provider Demographics
NPI:1356967210
Name:WI-KY CARE, LLC
Entity type:Organization
Organization Name:WI-KY CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:502-542-0014
Mailing Address - Street 1:1268 FROGTOWN RD
Mailing Address - Street 2:
Mailing Address - City:SADIEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40370-9548
Mailing Address - Country:US
Mailing Address - Phone:502-542-0014
Mailing Address - Fax:
Practice Address - Street 1:198 BEVINS LN STE A
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8533
Practice Address - Country:US
Practice Address - Phone:502-542-0014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-17
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7205516OtherSTATE LICENSURE