Organization Active NPI

Homeplace Support Service, LLC

  • Case Management Agency
  • Danville, KY
National Provider Identifier
1689893836
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
251B00000X Issued in KY
Legal business name
HOMEPLACE SUPPORT SERVICE, LLC
Practice address
215 S 4TH St
Danville, KY 40422-1827
Phone
(859) 936-2010
Fax
(859) 936-2099
NPI assigned
Apr 25, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Charlotte Jackson
Title
Program Supervisor
Phone
(859) 936-2010

Specialties & licenses 1

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

Addresses

Primary practice location

215 S 4TH St
Danville, KY 40422-1827

Mailing address

215 S 4TH St
Danville, KY 40422-1827
Phone (859) 936-2010

Other identifiers 1

IdentifierTypeStateIssuer
33001249MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
Homeplace Support Service 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

215 S 4th St
Danville, KY 40422
Phone (859) 238-7611

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689893836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 S 4TH ST",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404221827",
            "telephone_number": "859-936-2010",
            "fax_number": "859-936-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S 4TH ST",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404221827",
            "telephone_number": "859-936-2010",
            "fax_number": "859-936-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMEPLACE SUPPORT SERVICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "PROGRAM SUPERVISOR",
        "authorized_official_telephone_number": "859-936-2010"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "KY",
            "license": "251B00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33001249",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, 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.