The Council on Developmental Disabilities, Inc.

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

THE COUNCIL ON DEVELOPMENTAL DISABILITIES, INC.

Practice address

1151 S 4TH St
Louisville, KY 40203-3101

Phone

(502) 584-1239

NPI assigned

Feb 20, 2015

Last updated

Feb 20, 2015By 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

Mr. Donovan A Fornwalt

Title

Chief Executive Officer

Phone

(502) 584-1239

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1424390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424390400000",
    "number": "1710379292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 S 4TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402033101",
            "telephone_number": "502-584-1239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 S 4TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402033101",
            "telephone_number": "502-584-1239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE COUNCIL ON DEVELOPMENTAL DISABILITIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-20",
        "last_updated": "2015-02-20",
        "status": "A",
        "authorized_official_last_name": "FORNWALT",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "502-584-1239",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Louisville, KY
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• Case Management Agency in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; 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.