Residential Care Center of Paducah

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

100626 Issued in KY

Legal business name

RESIDENTIAL CARE CENTER OF PADUCAH

Practice address

2301 Irvin Cobb Dr
Paducah, KY 42003-6447

Phone

(270) 442-6441

Fax

(270) 442-0283

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Randall Shelby

Title

Administrator

Phone

(270) 442-6441

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376767335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 IRVIN COBB DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420036447",
            "telephone_number": "270-442-6441",
            "fax_number": "270-442-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 IRVIN COBB DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420036447",
            "telephone_number": "270-442-6441",
            "fax_number": "270-442-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENTIAL CARE CENTER OF PADUCAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHELBY",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "270-442-6441",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "KY",
            "license": "100626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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.