Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Cedar Lake Lodge, Inc.

Q: What type of organization is Cedar Lake Lodge, Inc.?

Cedar Lake Lodge, Inc. is registered in NPPES as a Intellectual Disabilities Intermediate Care Facility (its primary provider taxonomy).

Intellectual Disabilities Intermediate Care Facility in Louisville, KY · enumerated 2007 · authorized official Courtney Grimes, Program Billing & Reimb Supervisor.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1568508190

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Registry record

Entity type Organization (Type 2)

Legal business name Cedar Lake Lodge, Inc.

Practice address 9505 Williamsburg Plz Ste 200, Louisville, KY, 40222

Phone (502) 265-8389

Fax (502) 425-3540

Enumeration date Jan 30, 2007

Last updated in NPPES Dec 21, 2020

Taxonomy & classification

310500000X Mental Illness Intermediate Care Facility Nursing & Custodial Care Facilities · License 101120 (KY) Secondary

313M00000X Nursing Facility/Intermediate Care Facility Nursing & Custodial Care Facilities · License 101119 (KY) Secondary

315P00000X Intellectual Disabilities Intermediate Care Facility Nursing & Custodial Care Facilities Secondary

320900000X Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Residential Treatment Facilities Secondary

385HR2060X Child Intellectual and/or Developmental Disabilities Respite Care Respite Care Facility Secondary

315P00000X Intellectual Disabilities Intermediate Care Facility Nursing & Custodial Care Facilities · License 100450 (KY) Primary

Authorized official

Name Courtney Grimes

Title Program Billing & Reimb Supervisor

Phone (025) 265-8389

Other identifiers

Identifier	Type	State	Issuer
43000512	Medicaid	KY	-
11906153	Medicaid	KY	-
33200353	Medicaid	KY	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What is a Type 2 NPI?

A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

What type of organization is Cedar Lake Lodge, Inc.?

Cedar Lake Lodge, Inc. is registered in NPPES as a Intellectual Disabilities Intermediate Care Facility (its primary provider taxonomy).

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-12-21.