Organization
PPL REHAB SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY HICKS PHD (OWNER)
(502) 262-2887
Entity
Organization
Contact information
Practice address
8206 HIGHVIEW CT, CRESTWOOD, KY 40014-8105
(502) 262-2887
Mailing address
8206 HIGHVIEW CT, CRESTWOOD, KY 40014-8105
(502) 262-2887
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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