NPI 1578628392

Light Psychiatric Services, Psc

Organisation Preferred Provider Organization Louisville, KY

Practice location

Address: 13113 Eastpoint Park Blvd Suite D, Louisville, KY 40223-4191
Phone: (502) 244-5437
Fax: (502) 244-5003

Authorised official

Name: Michael John Light
Title: Ceo
Phone: (502) 244-5437

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 36355 (KY)

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Registry record

NPI: 1578628392
Entity type: Organization
NPI issued: 22 Dec 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.