Organization
PROVIDENCE OF LOUISVILLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON W WRIGHT (OWNER/PARTNER)
(502) 802-7636
Entity
Organization
Contact information
Practice address
17014 ASHBURTON DR, LOUISVILLE, KY 40245-5713
(502) 689-2106
Mailing address
17014 ASHBURTON DR, LOUISVILLE, KY 40245-5713
(502) 689-2106
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/12/2015
Last updated
11/12/2015
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