Community Life Connections, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

COMMUNITY LIFE CONNECTIONS, LLC

Practice address

253 Farmer LN
Bowling Green, KY 42104-8544

Phone

(270) 320-4868

NPI assigned

Dec 30, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Katherine Elizabeth Stacks

Title

Owner

Phone

(270) 320-4868

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1588029987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 FARMER LN",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421048544",
            "telephone_number": "270-320-4868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 FARMER LN",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421048544",
            "telephone_number": "270-320-4868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY LIFE CONNECTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "STACKS",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-320-4868",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Makenzie Condiff, PHARMD

• In Home Supportive Care Agency in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• In Home Supportive Care Agency in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.