Provider Demographics
NPI:1770544017
Name:FRIENDS AND COMPANIONS, LLC
Entity type:Organization
Organization Name:FRIENDS AND COMPANIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:606-877-1135
Mailing Address - Street 1:125 ENTERPRISE LANE
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-2012
Mailing Address - Country:US
Mailing Address - Phone:606-877-3357
Mailing Address - Fax:606-864-3725
Practice Address - Street 1:125 ENTERPRISE LANE
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-2012
Practice Address - Country:US
Practice Address - Phone:606-877-3357
Practice Address - Fax:606-864-3725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY750070252Y00000X
KY261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY43010636Medicaid