Organization Name: | THE HOME OF THE INNOCENTS, INC. |
NPI Number: | 1003115940 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GORDON S BROWN (PRESIDENT AND CEO) |
Mailing Address: | 1100 E Market St Louisville |
State: | KY US |
Postal Code: | 402061838 |
Phone Number: | 5025961000 |
Fax Number: | 5025961410 |
NPI Enumeration Date: | 03/17/2011 |
NPI Last Update Date: | 03/17/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 740143 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |