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Organization

PCB PROPERTIES LLC

Active
Other names
Way Maker Recovery
Organization subpart
No

Provider details

NPI number
Authorized official
W PAUL BUCKINGHAM LCSW (MEMBER)
(325) 812-5661
Entity
Organization

Contact information

Practice address
1705 W CHESTNUT ST, LOUISVILLE, KY 40203-1609
(502) 554-2797
Mailing address
1705 W CHESTNUT ST, LOUISVILLE, KY 40203-1609
(502) 554-2797

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7101016660
KY
Enumeration date
02/21/2024
Last updated
02/25/2025
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