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Organization

REBIRTH & RENEWAL FAMILY RESOURCE CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SANDRA MARSHALL-KING (OWNER)
(502) 592-2009
Entity
Organization

Contact information

Practice address
2900 W BROADWAY STE 4, LOUISVILLE, KY 40211-1281
(502) 592-2009
Mailing address
2900 W BROADWAY STE 4, LOUISVILLE, KY 40211-1281
(502) 592-2009

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100542650
KY
Enumeration date
07/24/2018
Last updated
02/26/2022
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