Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Cedar Lake Lodge/Sycamore Run

Organization Mental Illness Intermediate Care Facility · NPI 1790232577

Cedar Lake Lodge/Sycamore Run is a Mental Illness Intermediate Care Facility in Louisville, Kentucky. Licensed in Kentucky. Registered with an NPI since 2016.

Licensed in
KY
In the registry since
2016
Specialties on file
2

Practice location Address checks out

9505 Williamsburg Plz Ste 200
Louisville, KY 40222-5082
Phone: (502) 495-4953
Fax: (502) 425-3540
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual Disabilities Intermediate Care Facility (primary) Taxonomy 315P00000X · Licence 101247 (KY)
Mental Illness Intermediate Care Facility Taxonomy 310500000X · Licence 101246 (KY)

Record details

NPI number1790232577
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Courtney Grimes — Reimbursement Specialist · (502) 495-4953
NPI enumeratedSeptember 8, 2016
Last updated in NPPESJanuary 31, 2022
Certification dateJanuary 31, 2022
Mailing address9505 Williamsburg Plz, Ste 200, Louisville, KY 40222-5082

Other providers in Louisville