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KENTUCKY LIFE SOURCE INC
NPI 1083471262
Community/Behavioral Health in Louisville, KY

Active since March 04, 2024
2619 W BROADWAY, LOUISVILLE, KY 40211(502) 303-7665 Get Directions Write a Review

NPPES record last updated: March 13, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 13, 2025, Mar 4, 2024 (2 updates tracked since 2024).

About Kentucky Life Source Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENTUCKY LIFE SOURCE INC (NPI 1083471262) is a healthcare organization registered as a community/behavioral health in Louisville, Kentucky and active in the NPI registry since March 2024. The organization lists Jacqueline Sanders, Credentialing Admin, as its authorized official.

NPPES Registry Identity

NPI1083471262
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameKENTUCKY LIFE SOURCE INC
Location Address2619 W BROADWAYLouisville, KY 40211-1332
Mailing Address2619 W BroadwayLouisville, KY 40211-1332 · (502) 303-7665
Phone(502) 303-7665
Organization SubpartNo
Authorized OfficialJacqueline SandersCredentialing Admin · (502) 365-3394
Enumeration DateMarch 4, 2024
Last NPPES UpdateMarch 13, 20252 updates tracked since enumeration
NPPES CertifiedMarch 13, 2025
✔ NPI 1083471262 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
2619 W BROADWAY, Louisville, KY 40211
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RIVERSTONE CHILDREN'S HOME INC.
Residential Treatment Facility, Emotionally Disturbed Children
2619 W BROADWAY
LOUISVILLE, KY 40211
Jefferson County (502) 541-8583

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kentucky Life Source Inc's NPI number?

The NPI number for Kentucky Life Source Inc is 1083471262. It was assigned to this organization in the NPPES registry on March 4, 2024.

Where is Kentucky Life Source Inc located?

Kentucky Life Source Inc is located at 2619 W Broadway, Louisville, KY 40211. The listed phone number is (502) 303-7665.

What is Kentucky Life Source Inc's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Kentucky Life Source Inc was last updated on March 13, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.