Organization
GODS GRACE OF KENTUCKY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA WHITE (OWNER)
(502) 855-9122
Entity
Organization
Contact information
Practice address
500 BEECHER ST, LOUISVILLE, KY 40215-2804
(203) 850-1630
Mailing address
500 BEECHER ST, LOUISVILLE, KY 40215-2804
(203) 850-1630
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/24/2023
Last updated
07/24/2023
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