Provider Demographics
NPI:1841355922
Name:COMMUNITY LIVING, INC.
Entity type:Organization
Organization Name:COMMUNITY LIVING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ZARICKI
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:502-585-5272
Mailing Address - Street 1:333 GUTHRIE ST
Mailing Address - Street 2:SUITE 308
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1829
Mailing Address - Country:US
Mailing Address - Phone:502-585-5272
Mailing Address - Fax:502-585-5277
Practice Address - Street 1:333 GUTHRIE ST
Practice Address - Street 2:SUITE 308
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1829
Practice Address - Country:US
Practice Address - Phone:502-585-5272
Practice Address - Fax:502-585-5277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251E00000XAgenciesHome Health
Not Answered385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3390021800Medicaid