# UNIVERSITY OF LOUISVILLE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Children and Youth Project-Adolescent Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528209350
- **Authorized official:** DR. GERARD RABALAIS MD (CHAIRMAN)
- **Authorized official phone:** (502) 852-8600

## Contact information

- **Practice address:** 555 S FLOYD ST, LOUISVILLE, KY 40202-3822
- **Practice address phone:** (502) 852-5588
- **Practice address fax:** (502) 852-5630
- **Mailing address:** PO BOX 2469, LOUISVILLE, KY 40201-2469
- **Mailing address phone:** (502) 852-8500
- **Mailing address fax:** (502) 852-8556

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | 29710 | KY | Yes |

## Other

- **Enumeration date:** 03/06/2009
- **Last updated:** 07/09/2012