Provider Demographics
NPI:1649942830
Name:DEANNA'S HOME
Entity type:Organization
Organization Name:DEANNA'S HOME
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEENA
Authorized Official - Middle Name:L
Authorized Official - Last Name:IVORY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:502-445-2808
Mailing Address - Street 1:18811 WEATHERFORD CIR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-6228
Mailing Address - Country:US
Mailing Address - Phone:502-445-2808
Mailing Address - Fax:
Practice Address - Street 1:6503 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40258-3907
Practice Address - Country:US
Practice Address - Phone:502-445-2808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-05
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness