4112 Fern Valley Road Ops LLC
Substance Abuse Rehabilitation Facility in Louisville, KY. Organization (NPI-2).
NPI number1124862750
StatusActive
Last updated in NPPESJun 19, 2024
Details
- NPI
- 1124862750
- Entity type
- Organization (NPI-2)
- Legal business name
- 4112 Fern Valley Road Ops LLC
- Organization subpart
- No
- Enumeration date
- Jun 19, 2024
- Certification date
- Jun 19, 2024
- Last updated
- Jun 19, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 324500000X | Substance Abuse Rehabilitation Facility | – | – | Yes |
Practice location
4112 Fern Valley RdLouisville, KY 40219-1973
Phone 502-964-2699 · Fax 833-728-0420
Mailing address
133 Holiday Ct Ste 102Franklin, TN 37067-1386
Phone 615-281-9050
Authorized official
Alicia Neal
Manager, Cred & Contracting
6152819050
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