Organization
4112 FERN VALLEY ROAD OPS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA NEAL (MANAGER, CRED & CONTRACTING)
(615) 281-9050
Entity
Organization
Contact information
Practice address
4112 FERN VALLEY RD, LOUISVILLE, KY 40219-1973
(502) 964-2699
(833) 728-0420
Mailing address
133 HOLIDAY CT STE 102, FRANKLIN, TN 37067-1386
(615) 281-9050
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/19/2024
Last updated
06/19/2024
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