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Cedar Lake Lodge/Sycamore Run

Intellectual Disabilities Intermediate Care Facility in Louisville, KY · enumerated 2016 · authorized official Courtney Grimes, Reimbursement Specialist.

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

National Provider Identifier

1790232577

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Registry record

Entity type Organization (Type 2)
Legal business name Cedar Lake Lodge/Sycamore Run
Practice address 9505 Williamsburg Plz, Ste 200, Louisville, KY, 40222
Phone (502) 495-4953
Fax (502) 425-3540
Enumeration date Sep 8, 2016
Last updated in NPPES Jan 31, 2022

Taxonomy & classification

310500000X Mental Illness Intermediate Care Facility Nursing & Custodial Care Facilities · License 101246 (KY) Secondary
315P00000X Intellectual Disabilities Intermediate Care Facility Nursing & Custodial Care Facilities · License 101247 (KY) Primary

Authorized official

Name Courtney Grimes
Title Reimbursement Specialist
Phone (502) 495-4953

Other identifiers

Identifier Type State Issuer
101246 Medicaid KY -
101247 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.

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Frequently asked questions

What type of organization is Cedar Lake Lodge/Sycamore Run?
Cedar Lake Lodge/Sycamore Run is registered in NPPES as a Intellectual Disabilities Intermediate Care Facility (its primary provider taxonomy).
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.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2022-01-31.