Organization Active NPI

Eta Day Care Center LLC

  • Case Management Agency
  • Louisville, KY
National Provider Identifier
1184770562
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
750110 Issued in KY
Legal business name
ETA DAY CARE CENTER LLC
Practice address
724 So 44TH Street
Louisville, KY 40211
Phone
(502) 776-7656
Fax
(502) 776-7640
NPI assigned
Jan 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Rose H Walton
Title
Owner
Phone
(502) 776-7656

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 750110 KY Primary

Addresses

Primary practice location

724 So 44TH Street
Louisville, KY 40211

Mailing address

PO Box 1051
Louisville, KY 40201-1051
Phone (502) 776-7656

Other identifiers 1

IdentifierTypeStateIssuer
33000027MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
Eta Day Care Center LLC2 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

724 S 44th St
Louisville, KY 40211
Phone (502) 776-7656

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184770562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1051",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402011051",
            "telephone_number": "502-776-7656",
            "fax_number": "502-776-7640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 SO 44TH STREET",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40211",
            "telephone_number": "502-776-7656",
            "fax_number": "502-776-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETA DAY CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-776-7656",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "KY",
            "license": "750110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33000027",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.