NPI 1578871679
Commonwealth of Kentucky
Practice location
- Address
- 10510 Lagrange Road, Louisville, KY 40223
- Phone
- (502) 253-7000
- Fax
- (503) 253-7044
Authorised official
- Name
- Jennifer Moore
- Title
- Assistant Director
- Phone
- (502) 782-6117
Registered specialties (4)
Psychiatric Hospital
Primary
Psychiatry Physician
General Practice Physician
Psychiatric Hospital
Registry record
- NPI
- 1578871679
- Entity type
- Organization
- NPI issued
- 23 Sep 2010
- Record last updated
- 30 Oct 2024
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.