Provider Demographics
NPI:1881352912
Name:DEANNAS ADULT DAY CENTER
Entity type:Organization
Organization Name:DEANNAS ADULT DAY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEENA
Authorized Official - Middle Name:L
Authorized Official - Last Name:IVORY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-445-2808
Mailing Address - Street 1:6503 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-3907
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:2021-12-06
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No251J00000XAgenciesNursing Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities