LIFETIME POTENTIALS, INC. (NPI# 1710012000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1710012000 |
Entity Type | Organization |
Organization Name | LIFETIME POTENTIALS, INC. |
Practice Address |
43 Lj Lane Jackson KY 41339 |
Mailing Address |
Po Box 798 Jackson KY 41339 |
Practice Telephone | 6066930994 |
Practice Fax Number | 6066930959 |
Mailing Telephone | 6066930994 |
Mailing Fax Number | 6066930959 |
Enumeration Date | 2007-02-23 |
Last Update Date | 2017-10-11 |
Authorized Official Name | KAY LEE VANOVER (PRESIDENT) |
Authorized Official Telephone | 6066930994 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 251C00000X | Day Training, Developmentally Disabled Services | 007700784 | KY | Agencies |
Y | 251C00000X | Day Training, Developmentally Disabled Services | KY | Agencies |
State | Issuer | Identifier | Type Code |
---|---|---|---|
KY | 3300125600 | 05 | |
KY | 7100179820 | 05 | |
KY | 33001256 | 05 |
Street Address |
43 LJ LANE |
City | JACKSON |
State | KY |
Zip Code | 41339 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841890662 | Angela Shawn Bradley | Pharmacist | 1589 Ky Hwy 15 South, Jackson, KY 41339 | 2020-10-30 |
1871191734 | Ranita Greer | Pharmacist | 59 Ky-15 N, Jackson, KY 41339 | 2020-10-13 |
1336763135 | Jill Elaine Beattie Green | Occupational Therapist | 100 Ky-15, Jackson, KY 41339 | 2020-06-08 |
1023641446 | Andreanna Gibbs | Physical Therapy Assistant | 100 Hwy 15, Jackson, KY 41339 | 2020-02-13 |
1144797754 | Visionary Rehabilitation Services, LLC | Speech-Language Pathologist | 100 Kentucky Hwy 15 South, Suite 136, Jackson, KY 41339 | 2018-11-01 |
1477081206 | Trending Upwards | Counselor | 1754 Highway 15 N, Jackson, KY 41339 | 2017-05-24 |
1508225996 | Jessica Williams | Pharmacist | 842 Highway 15 N, Jackson, KY 41339 | 2016-02-15 |
1245637255 | Breathitt County Ambulance, Inc. | Ambulance | 440 Highway 1812 North, Jackson, KY 41339 | 2014-11-20 |
1265784045 | Jonathan Charles Morris | Physical Therapist | 695 Ky Hwy 15 N, Ste 3, Jackson, KY 41339 | 2012-10-04 |
1649539958 | Henry Price Sewell IIi IIi | Family Medicine | 170 Picnic Hill Rd, Jackson, KY 41339 | 2012-05-07 |
Find all providers in zip 41339 |
Taxonomy Code | 251C00000X |
Grouping | Agencies |
Classification | Day Training, Developmentally Disabled Services |
These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669037701 | Amanda Elizabeth Derousse | Day Training, Developmentally Disabled Services | 1527 Deerwood Dr, Jackson, MO 63755-4148 | 2019-05-03 |
1134617350 | Golden Moments Home Care, LLC | Day Training, Developmentally Disabled Services | 201 Airways Blvd, Jackson, TN 38301-5800 | 2018-04-24 |
1144752874 | Robert Zangrillo | Day Training, Developmentally Disabled Services | 7 Bailey Ct, Jackson, NJ 08527-4459 | 2017-03-31 |
1235679523 | Doris C. Bridges | Day Training, Developmentally Disabled Services | 3928 Allen Dr, Jackson, MS 39212-5379 | 2017-03-06 |
1366995110 | Senior Services, LLC | Day Training, Developmentally Disabled Services | 21 Northtown Dr, Jackson, MS 39211-3016 | 2016-07-28 |
1891064002 | Tennessee Personal Assistance, Inc | Day Training, Developmentally Disabled Services | 31b Bowling Dr, Jackson, TN 38305-6100 | 2011-12-16 |
1508150160 | Never Forgotten Ministries | Day Training, Developmentally Disabled Services | 1122 Fincherville Rd, Jackson, GA 30233-3433 | 2011-06-01 |
1952526774 | Sitters & More, Inc. | Day Training, Developmentally Disabled Services | 125 Stonebridge Blvd Ste A, Jackson, TN 38305-2159 | 2007-04-16 |
1902931314 | Madison Haywood County Developmental Services, Inc | Day Training, Developmentally Disabled Services | 38 Garland Dr, Jackson, TN 38305-3602 | 2007-02-23 |
1639223852 | A.r.e. Inc., of Jackson | Day Training, Developmentally Disabled Services | 1009 W Michigan Ave, Jackson, MI 49202-4120 | 2007-01-23 |
Find all providers in JACKSON |
Please comment or provide details below to improve the information on LIFETIME POTENTIALS, INC..
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.