Cedar Lake Lodge/Sycamore Run
NPI 1790232577ActiveOrganization· Intermediate Care Facility, Intellectual Disabilities· Louisville, KY
Intermediate Care Facility, Intellectual Disabilities in Louisville, Kentucky, registered in NPPES in September 2016. The authorized official on file is Courtney Elaine Grimes, Reimbursement Specialist.
Overview
| NPI | 1790232577 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 8, 2016 |
| Last updated in NPPES | Jan 31, 2022 |
| Certified by provider | Jan 31, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Intermediate Care Facility, Intellectual Disabilities Primary | 315P00000X | 101247 | KY |
| Intermediate Care Facility, Mental Illness | 310500000X | 101246 | KY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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