Lifetime Potentials, Inc.

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

LIFETIME POTENTIALS, INC.

Practice address

43 LJ Lane
Jackson, KY 41339

Phone

(606) 693-0994

Fax

(606) 693-0959

NPI assigned

Feb 23, 2007

Last updated

Oct 11, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kay Lee Vanover

Title

President

Phone

(606) 693-0994

Specialties & licenses 2

Addresses

Other identifiers 3

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507680000000",
    "number": "1710012000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 798",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "41339",
            "telephone_number": "606-693-0994",
            "fax_number": "606-693-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 LJ LANE",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "41339",
            "telephone_number": "606-693-0994",
            "fax_number": "606-693-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME POTENTIALS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2017-10-11",
        "status": "A",
        "authorized_official_last_name": "VANOVER",
        "authorized_official_first_name": "KAY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-693-0994"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "KY",
            "license": "007700784",
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33001256",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3300125600",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100179820",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Jackson, KY
• Providers in Jackson, 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 Oct 11, 2017; 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.