Provider Demographics
NPI:1518206135
Name:HEARTSONG MEMORY CARE, LLC
Entity type:Organization
Organization Name:HEARTSONG MEMORY CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-452-1400
Mailing Address - Street 1:9300 STONESTREET RD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40272-2863
Mailing Address - Country:US
Mailing Address - Phone:502-935-1133
Mailing Address - Fax:502-935-1188
Practice Address - Street 1:9300 STONESTREET RD
Practice Address - Street 2:SUITE 700
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272-2863
Practice Address - Country:US
Practice Address - Phone:502-935-1133
Practice Address - Fax:502-935-1188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY750183261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care