Cedar Lake Residences, Inc.

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

CEDAR LAKE RESIDENCES, INC.

Practice address

7984 New Lagrange Rd
Louisville, KY 40222-4718

Phone

(502) 327-7706

Fax

(502) 327-7417

NPI assigned

Jun 1, 2007

Organization subpart

No

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

Authorized official

Name

Michelle Carol Kersting

Title

Assistant Controller

Phone

(502) 327-7706

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Cedar Lake Residences Inc2 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.

• Cedar Lake Rehabilitation Services

  • Physical Therapy Clinic/Center
  • Louisville, KY
  • NPI 1790165561
  NPD tax ID

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396947461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7984 NEW LAGRANGE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224718",
            "telephone_number": "502-327-7706",
            "fax_number": "502-327-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7984 NEW LAGRANGE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224718",
            "telephone_number": "502-327-7706",
            "fax_number": "502-327-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR LAKE RESIDENCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KERSTING",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "ASSISTANT CONTROLLER",
        "authorized_official_telephone_number": "502-327-7706"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43000900",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathanial Cecil, PHARMD
• Robert A Cecil Jr., P.T.
• Cedar Lake Lodge, Inc.
• Cedar Lake Lodge/Sycamore Run
• Cedar Lake Rehabilitation Services
• Cedar Lake Residences, Inc.
• David Thomas Celello, D.M.D.
• Paul C Celestre, MD
• Daven Ceniza
• Center for Accessible Living

• Developmentally Disabled Services Day Training Agency in Louisville, KY
• Providers in Louisville, KY by specialty
• Developmentally Disabled Services Day Training Agency in Kentucky

• 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.