Provider Demographics
NPI: | 1154458057 |
---|---|
Name: | THE BEST KIDS, PLC |
Entity type: | Organization |
Organization Name: | THE BEST KIDS, PLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PHYSICIAN |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | HAROLD |
Authorized Official - Middle Name: | J |
Authorized Official - Last Name: | LIVERA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 502-895-9421 |
Mailing Address - Street 1: | 217 BRECKENRIDGE LN |
Mailing Address - Street 2: | |
Mailing Address - City: | LOUISVILLE |
Mailing Address - State: | KY |
Mailing Address - Zip Code: | 40207-3858 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 502-895-9421 |
Mailing Address - Fax: | 502-899-5762 |
Practice Address - Street 1: | 217 BRECKENRIDGE LN |
Practice Address - Street 2: | |
Practice Address - City: | LOUISVILLE |
Practice Address - State: | KY |
Practice Address - Zip Code: | 40207-3858 |
Practice Address - Country: | US |
Practice Address - Phone: | 502-895-9421 |
Practice Address - Fax: | 502-899-5762 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-02-27 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
KY | 25408 | 208000000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Single Specialty |