| Organization Name: | LINCOLN TRAIL ELEMENTERY SATELLITE CLINIC |
| NPI Number: | 1457634420 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LINDA M SIMS (DIRECTOR) |
| Mailing Address: | 3154 Bardstown Rd Elizabethtown |
| State: | KY US |
| Postal Code: | 427017513 |
| Phone Number: | 2707691601 |
| Fax Number: | 2707657274 |
| NPI Enumeration Date: | 09/26/2011 |
| NPI Last Update Date: | 09/26/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |