Organization
GREATER LOUISVILLE COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH MCKENZIE CADC (EXECUTIVE DIRECTOR)
(502) 587-9737
Entity
Organization
Contact information
Practice address
332 W BROADWAY STE 905, LOUISVILLE, KY 40202-2133
(502) 587-9737
Mailing address
332 W BROADWAY STE 905, LOUISVILLE, KY 40202-2133
(502) 587-9737
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
810005
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100323580
—
KY
Enumeration date
08/07/2014
Last updated
11/01/2017
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