Organization
CREATIVE SPIRITS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA D HARRIS-GRAY LCADC (EXECUTIVE DIRECTOR)
(502) 254-9555
Entity
Organization
Contact information
Practice address
12730 TOWNEPARK WAY, LOUISVILLE, KY 40243-2303
(502) 254-9555
(502) 254-9554
Mailing address
12730 TOWNEPARK WAY, LOUISVILLE, KY 40243-2303
(502) 254-9555
(502) 254-9554
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
800216
KY
Other
Enumeration date
04/26/2016
Last updated
04/26/2016
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