MDH MANAGEMENT GROUP, INC. (NPI# 1568519510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568519510 |
| Entity Type | Organization |
| Organization Name | MDH MANAGEMENT GROUP, INC. |
| Practice Address |
12706 Crestmoor Cir Prospect KY 40059-9181 |
| Practice Telephone | 5022920734 |
| Mailing Telephone | 5022920734 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DREW HAYNES (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 5022920734 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 33000621 | KY | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 3300062100 | 05 |
| Street Address |
12706 CRESTMOOR CIR |
| City | PROSPECT |
| State | KY |
| Zip Code | 40059-9181 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750594420 | Trio Community | Community/Behavioral Health | 12706 Crestmoor Cir, Prospect, KY 40059-9181 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932744919 | Cheryl L Young | Counselor | 1703 Victory Court, Prospect, KY 40059 | 2019-11-13 |
| 1790276806 | Harrods Creek Vol Fire Dept Inc | Ambulance | 8905 Us Highway 42, Prospect, KY 40059 | 2018-05-24 |
| 1952754475 | Prospect Pharmacy LLC | Pharmacy | 9549-b Us Highway 42, Prospect, KY 40059 | 2016-07-20 |
| 1972959740 | Raina Chandiramani | Dentist | 11838 Lakestone Way, Prospect, KY 40059 | 2016-05-10 |
| 1750629416 | Sanford Simon | Family Medicine | 6805 Hunter Run Place, Prospect, KY 40059 | 2013-01-30 |
| 1568707743 | Zorre Zeno Kimura | Physical Therapist | 10211 Worthington Lane, Prospect, KY 40059 | 2012-11-29 |
| 1487806634 | Jaclyn Engelsher | Acupuncturist | 10605 Meeting Street, Suite 102, Prospect, KY 40059 | 2008-10-21 |
| 1740454289 | Emily J. Baskin | Massage Therapist | 9509 Us Hwy 42, Suite 207, Prospect, KY 40059 | 2008-04-16 |
| 1942304647 | Paul Thomas Lavelle | Dentist | 13104 Us Hwy 42, Prospect, KY 40059 | 2006-09-12 |
| 1710924055 | Nasir Gardezi | Internal Medicine | 9500 Hayden Creek Court, Prospect, KY 40059 | 2006-06-02 |
| Find all providers in zip 40059 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871137414 | Loving Care, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9105 Kingdom Way, Louisville, KY 40291-3131 | 2019-11-06 |
| 1245883859 | Community and Family Empowerment | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11106 Decimal Dr, Louisville, KY 40299-2440 | 2019-07-23 |
| 1740840925 | Infinite Abilities & Supports, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2012 N Highway 1247, Somerset, KY 42503-4601 | 2019-06-19 |
| 1215423827 | Comfortable Living LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 525 Williams Rd, Nicholasville, KY 40356-1988 | 2018-07-06 |
| 1740783679 | Gateway Residential Supports | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4321 Southern Pkwy, Louisville, KY 40214-1583 | 2018-03-16 |
| 1023518289 | Communitty Options, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7979 Alexandria Pike, Alexandria, KY 41001-1157 | 2018-02-14 |
| 1922527522 | Modern Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 104 Nancy Cox Dr Ste D, Campbellsville, KY 42718-6835 | 2017-09-14 |
| 1043650245 | D&s Residential Services, Lp | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 259 R Old Flemingsburg Rd., Morehead, KY 40351-1047 | 2013-07-02 |
| 1164787958 | Agape Community Living LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4200 Wallingford Ln, Louisville, KY 40218-2720 | 2012-07-09 |
| 1114299765 | Tranquility Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3935 Rockhouse Creek Rd, Salyersville, KY 41465-9099 | 2012-01-28 |
| Find all providers with the same taxonomy | ||||
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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.