Momology Maternal Wellness Club
Community/Behavioral Health in Louisville, KY. Organization (NPI-2).
NPI number1629664313
StatusActive
Last updated in NPPESDec 16, 2020
Details
- NPI
- 1629664313
- Entity type
- Organization (NPI-2)
- Legal business name
- Momology Maternal Wellness Club
- Organization subpart
- No
- Enumeration date
- Dec 16, 2020
- Certification date
- Dec 16, 2020
- Last updated
- Dec 16, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
Practice location
4614 Dohn RdLouisville, KY 40216-2902
Phone 502-354-8424 · Fax 502-632-1432
Mailing address
4614 Dohn RdLouisville, KY 40216-2902
Phone 502-354-8424 · Fax 502-632-1432
Authorized official
Jacqueline Sanders
Credentialing Administrator
5026302036
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