Organization
ALTERNATIVE YOUTH SERVICES, INC.
Active
Other names
MAGNOLIA ACADEMY
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEENA OMBRES (PRIVACY OFFICER)
(502) 394-2387
Entity
Organization
Contact information
Practice address
120 FREEMAN DR, LEWISBURG, TN 37091-3047
(931) 359-3592
Mailing address
9901 LINN STATION RD, LOUISVILLE, KY 40223-3808
(800) 866-0860
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/14/2007
Last updated
07/28/2008
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