{"npi":"1679713630","type":"NPI-2","status":"active","name":{"display":"Commonwealth Of Kentucky","other":[],"organization_name":"COMMONWEALTH OF KENTUCKY","authorised_official":"Jennifer Moore"},"specialty":{"primary_taxonomy":"315P00000X","primary_taxonomy_description":"Intellectual Disabilities Intermediate Care Facility","slug":"intellectual-disabilities-intermediate-care-facility","schema_org_specialty":null,"all":[{"code":"315P00000X","description":"Intellectual Disabilities Intermediate Care Facility","primary":true,"state":"KY","license":"100426"}]},"addresses":[{"purpose":"LOCATION","street_1":"400 EASTWOOD DR","city":"SOMERSET","state":"KY","postal_code":"42501","country_code":"US","street_2":"2441 S. HWY 27","phone":"6066674068","fax":"6066774068"},{"purpose":"MAILING","street_1":"400 EASTWOOD DR","city":"SOMERSET","state":"KY","postal_code":"42501","country_code":"US","street_2":"2441 S. HWY 27","phone":"6066774068","fax":"6066774079"}],"license":{"state":"KY","number":"100426"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"11900016","state":"KY","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2009-03-03","last_updated":"2024-08-07","_meta":{"source":"NPPES","snapshot_date":"2024-08-07","doc_url":"https://findmynpi.com/api"}}