Organization · NPI-2

4418 Malcolm Avenue Ops LLC

Substance Abuse Rehabilitation Facility · Louisville, KY

NPI number1801630512
StatusActive
Last updated in NPPESMay 22, 2026

Details

NPI
1801630512
Entity type
Organization (NPI-2)
Legal business name
4418 Malcolm Avenue Ops LLC
Organization subpart
No
Enumeration date
Jun 19, 2024
Certification date
May 22, 2026
Last updated
May 22, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
324500000X Substance Abuse Rehabilitation Facility––Yes

Practice location

4418 Malcolm Ave
Louisville, KY 40215-1122

Phone 502-713-7017 · Fax 833-792-1347

Mailing address

133 Holiday Ct Ste 102
Franklin, TN 37067-1386

Phone 629-257-8260

Other practice locations

4419 Lasalle Avenue
Louisville, KY 40215-1122

Phone 855-950-5035

Authorized official

Alicia Neal
Director Of Managed Care
6292578260

Is something wrong?

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