Organization
ANGEL'S PLACE LLC
Active
Other names
CSP Recovery Services
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MONTEZ PERCELL (OWNER)
(502) 356-6035
Entity
Organization
Contact information
Practice address
939 BAXTER AVE, LOUISVILLE, KY 40204-2046
(812) 660-9936
Mailing address
621 LOUIS COLEMAN JR DR, LOUISVILLE, KY 40211-2952
(502) 356-6035
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/03/2024
Last updated
12/03/2024
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