NPIMap

Organization Active NPI

Northern Kentucky Living Centers LLC.

  • Adult Day Care Clinic/Center
  • Falmouth, KY
National Provider Identifier
1144346412
Registry record updated Dec 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
750108 Issued in KY
Legal business name
NORTHERN KENTUCKY LIVING CENTERS LLC.
Doing business as
The Clubhouse Adult Daycare Center
Practice address
208 Memory Drive
Falmouth, KY 41040
Phone
(859) 654-8900
Fax
(859) 654-1765
NPI assigned
Mar 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Heath R. Culberson
Title
Ceo
Phone
(859) 954-1494

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 750108 KY Primary

Addresses

Primary practice location

208 Memory Drive
Falmouth, KY 41040

Mailing address

P.O. Box 83
Falmouth, KY 41040
Phone (859) 954-1494

Other identifiers 2

IdentifierTypeStateIssuer
7100199920MedicaidKY
43000090MedicaidKY

Other names 1

  • The Clubhouse Adult Daycare Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bennetts Personal Care Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

208 Memory Dr
Falmouth, KY 41040
Phone (859) 654-8900

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417651200000",
    "number": "1144346412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 83",
            "city": "FALMOUTH",
            "state": "KY",
            "postal_code": "41040",
            "telephone_number": "859-954-1494",
            "fax_number": "859-654-1765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 MEMORY DRIVE",
            "city": "FALMOUTH",
            "state": "KY",
            "postal_code": "41040",
            "telephone_number": "859-654-8900",
            "fax_number": "859-654-1765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN KENTUCKY LIVING CENTERS LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2014-12-04",
        "status": "A",
        "authorized_official_last_name": "CULBERSON",
        "authorized_official_first_name": "HEATH",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "859-954-1494",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "KY",
            "license": "750108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100199920",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43000090",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Clubhouse Adult Daycare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Falmouth, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.