Louisville Center For Eating Disorders LLC
Clinic/Center, Adult Mental Health in Louisville, KY. Organization (NPI-2).
NPI number1982197737
StatusActive
Last updated in NPPESJul 28, 2026
Details
- NPI
- 1982197737
- Entity type
- Organization (NPI-2)
- Legal business name
- Louisville Center For Eating Disorders LLC
- Organization subpart
- No
- Enumeration date
- Jun 7, 2018
- Certification date
- Jul 28, 2026
- Last updated
- Jul 28, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | Yes |
| 103T00000X | Psychologist | – | – | |
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | – | – |
Practice location
11824 Ransum Dr # 200Louisville, KY 40243-2802
Phone 502-338-0608 · Fax 502-245-1888
Mailing address
11824 Ransum Dr Ste 200Louisville, KY 40243-2802
Phone 502-338-0608 · Fax 502-245-1888
Authorized official
Justin Brent Wallen
Business Manager
5023193105
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