CHRISTIAN COUNTY MANOR I LLC
NPI 1013720291
Assisted Living Facility - Assisted Living, Mental Illness in Hopkinsville, KY

NPI Status: Active since January 30, 2025

Contact Information

2820 RICHARD ST
HOPKINSVILLE, KY
ZIP 42240
Phone: (516) 708-3503

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  • Organization
  • Assisted Living Facility
  • Assisted Living, Mental Illness
  • CLIA Number: 18D2156320
  • CLIA Cert. Type: Other - COUNTY JAIL
  • CLIA Exp. Date: 10-15-2026

About CHRISTIAN COUNTY MANOR I LLC

This page provides the complete NPI Profile along with additional information for Christian County Manor I Llc, a provider established in Hopkinsville, Kentucky operating as a Assisted Living Facility, focusing in assisted living, mental illness . The healthcare provider is registered in the NPI registry with number 1013720291 assigned on January 2025. The practitioner's primary taxonomy code is 3104A0625X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Raquel Edery (Coo)

NPI
1013720291
Provider Name
CHRISTIAN COUNTY MANOR I LLC
Entity Type
Organization
Location Address
2820 RICHARD ST HOPKINSVILLE, KY 42240
Location Phone
(516) 708-3503
Mailing Address
455 CENTRAL AVE STE 215 CEDARHURST, NY 11516
Mailing Phone
(516) 708-3503
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-30-2025
Last Update Date
01-30-2025
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility Assisted Living, Mental Illness

Taxonomy Code
3104A0625X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

RAQUEL EDERY

Authorized Official Title
COO
Authorized Official Phone
(516) 708-3503

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
18D2156320
Facility Type
Other - COUNTY JAIL
Certificate Effective Date
October 16, 2024
Certificate Expiration Date
October 15, 2026
Laboratory Director
MR. ADAM SMITH
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Christian County Manor I Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1013720291, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 49. The final step is to find the difference between that total and the next multiple of ten (50 - 49 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
1
Doubled → 2
Pos 4
3
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
2
Unchanged
Pos 7
0
Doubled → 0
Pos 8
2
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 7 → 14 → 5 0 → 0 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 2 + 3 + 1 + 4 + 2 + 0 + 2 + 1 + 8 + 24 = 49

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 49 is 50. The difference is the calculated check digit.

50 - 49 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1013720291.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Custodial Care Facility (Adult Care Home)
2820 RICHARD ST
HOPKINSVILLE, KY 42240
Custodial Care Facility
2820 RICHARD ST
HOPKINSVILLE, KY 42240
Custodial Care Facility (Adult Care Home)
2820 RICHARD ST
HOPKINSVILLE, KY 42240

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1013720291, enumerated as an "organization" on January 30, 2025.

The provider is located at 2820 RICHARD ST HOPKINSVILLE, KY 42240 and the phone number is (516) 708-3503.

Assisted Living Facility with taxonomy code 3104A0625X and a focus in Assisted Living, Mental Illness.