Elderclub Adc Elderserve Inc.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

750118 Issued in KY

Legal business name

ELDERCLUB ADC ELDERSERVE INC.

Practice address

631 S 28TH St
Louisville, KY 40211-1369

Phone

(502) 776-3066

NPI assigned

Jan 24, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Harold D Jones

Title

Director of the Adc

Phone

(502) 776-3066

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ElderClub ADC Other name

Tax ID family

Elderclub Adc2 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.

• Elderserve, Inc.

  • Home Health Agency
  • Louisville, KY
  • NPI 1982886784
  NPD tax ID

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720133200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 S 28TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111369",
            "telephone_number": "502-776-3066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 S 28TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111369",
            "telephone_number": "502-776-3066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERCLUB ADC ELDERSERVE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR OF THE ADC",
        "authorized_official_telephone_number": "502-776-3066",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "KY",
            "license": "750118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43000215",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ElderClub ADC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Katherine Elder, PT
• Mary A. Elder, M.S.
• Susan Marie Elder, R.N.
• Taja Elder, NP
• Eldercare 4 Families
• Elderserve, Inc.
• Donald Paul Eldridge, D.C.
• Karin Eldridge
• Kirsten Eldridge, APRN
• Libby Jurado Eldridge, MA LMFT

• Adult Day Care Clinic/Center in Louisville, KY
• Providers in Louisville, KY by specialty
• Adult Day Care Clinic/Center 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.