Provider Demographics
NPI:1194419317
Name:2ND HOME ADULT DAY HEALTH CARE LLC
Entity type:Organization
Organization Name:2ND HOME ADULT DAY HEALTH CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLATGARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-315-4675
Mailing Address - Street 1:2432 REGENCY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3046
Mailing Address - Country:US
Mailing Address - Phone:270-315-4675
Mailing Address - Fax:
Practice Address - Street 1:2432 REGENCY RD STE 200
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3046
Practice Address - Country:US
Practice Address - Phone:270-315-4675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-08
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care