CEDAR LAKE LODGE, INC. (NPI# 1568508190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568508190 |
| Entity Type | Organization |
| Organization Name | CEDAR LAKE LODGE, INC. |
| Practice Address |
7984 New Lagrange Rd Louisville KY 40222-4718 |
| Practice Telephone | 5022227157 |
| Practice Fax Number | 5024253540 |
| Mailing Telephone | 5022227157 |
| Mailing Fax Number | 5024253540 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2010-11-22 |
| Authorized Official Name | MICHELLE CAROL KERSTING (ASSISTANT CONTROLLER) |
| Authorized Official Telephone | 5022227157 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310500000X | Intermediate Care Facility, Mental Illness | 101120 | KY | Nursing & Custodial Care Facilities |
| N | 313M00000X | Nursing Facility/Intermediate Care Facility | 101119 | KY | Nursing & Custodial Care Facilities |
| N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| N | 385HR2060X |
Respite Care Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
Respite Care Facility | ||
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 100450 | KY | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 43000512 | 05 | |
| KY | 11906153 | 05 | |
| KY | 33200353 | 05 |
| Street Address |
7984 NEW LAGRANGE RD |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40222-4718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487264172 | Hillary Louise Langley | Psychologist | 7984 New Lagrange Rd, Louisville, KY 40222-4718 | 2020-08-06 |
| 1710462908 | Lanie J Hopping | Psychologist | 7984 New Lagrange Rd, Louisville, KY 40222 | 2018-10-03 |
| 1750889127 | Laura Yeoman | Psychologist | 7984 New Lagrange Rd, Louisville, KY 40222 | 2018-01-31 |
| 1083934285 | Lisa Carol Steelsmith | Psychologist | 7984 New Lagrange Rd, Louisville, KY 40222 | 2010-06-10 |
| 1396947461 | Cedar Lake Residences, Inc. | Day Training, Developmentally Disabled Services | 7984 New Lagrange Rd, Louisville, KY 40222-4718 | 2007-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740881507 | Lucas Counseling and Consulting | Counselor | 8134 New Lagrange Road Suite 100, Louisville, KY 40222 | 2020-11-06 |
| 1700424157 | Hope4hearts Counseling LLC | Community/Behavioral Health | 7321 New Lagrange Road, Louisville, KY 40222 | 2019-12-17 |
| 1982162509 | Sydney Sleadd | Massage Therapist | 7505 New Lagrange Rd, Ste 101, Louisville, KY 40222 | 2019-03-04 |
| 1205390127 | Rebecca A Street | Marriage & Family Therapist | 8134 New La Grange Rd Ste 227, Louisville, KY 40222 | 2019-01-24 |
| 1689176166 | Andrew Pennington | Social Worker | 1015 Dorsey Ln., Louisville, KY 40222 | 2018-03-01 |
| 1578085957 | Megan Lusco | Case Manager/Care Coordinator | 312 Whittington Parkway, Suite 020, Louisville, KY 40222 | 2017-07-07 |
| 1083149868 | Kate Oliver Ray | Optometrist | 2420 Lime Kiln Ln Ste H, Louisville, KY 40222 | 2017-04-28 |
| 1578094736 | Jacqueline Ward | Speech-Language Pathologist | 910 Fenley Avenue, Louisville, KY 40222 | 2017-03-21 |
| 1295195907 | Carol Massey | Psychologist | 7400 Newlagrange Roed, 308, Louisville, KY 40222 | 2016-02-24 |
| 1588047260 | Melissa Cosby | Case Manager/Care Coordinator | 312 Whittington Parkway Suite 020, Louisville, KY 40222 | 2015-06-30 |
| Find all providers in zip 40222 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306017439 | The Academy for Individual Excellence, Inc. | Intermediate Care Facility, Mentally Retarded | 3101 Bluebird Ln, Louisville, KY 40299-3803 | 2008-03-17 |
| 1538356712 | Voca Corporation of Ohio | Intermediate Care Facility, Mentally Retarded | 4230 Lesh St, Louisville, OH 44641-8605 | 2007-10-01 |
| 1083785125 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 4401-4505 Louise Underwood Way, Louisville, KY 40216 | 2006-11-12 |
| 1598721383 | Petersen Health Quality, LLC | Intermediate Care Facility, Mentally Retarded | 52 Old Rte 45, Louisville, IL 62858-0116 | 2006-04-21 |
| 1043298979 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 5512 Del Maria Way, Louisville, KY 40291-1810 | 2005-12-30 |
| 1316241961 | Southern Home Care Services, Inc. | Intermediate Care Facility, Mentally Retarded | 9901 Linn Station Rd, Louisville, KY 40223-3808 | 2010-12-22 |
| 1275836124 | Southern Home Care Services, Inc. | Intermediate Care Facility, Mentally Retarded | 9901 Linn Station Rd, Louisville, KY 40223-3808 | 2010-12-15 |
| 1922233469 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 9901 Linn Station Rd, Louisville, KY 40223-3808 | 2009-05-28 |
| 1467624288 | Voca Corporation of Florida | Intermediate Care Facility, Mentally Retarded | 9901 Linn Station Rd, Louisville, KY 40223-3808 | 2008-04-01 |
| 1700057833 | Alternative Youth Services, Inc. | Intermediate Care Facility, Mentally Retarded | 200 High Rise Dr, Suite 155, Louisville, KY 40213-3252 | 2008-03-17 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40222 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.