Organization
PHC-CLEVELAND LLC
Active
Other names
Bolivar Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNETTA TRAYLOR (DIRECTOR)
(502) 596-6063
Entity
Organization
Contact information
Practice address
680 S 4TH ST, LOUISVILLE, KY 40202-2407
(502) 596-6063
(502) 212-8481
Mailing address
680 S 4TH ST, LOUISVILLE, KY 40202-2407
(502) 212-8481
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
—
—
Other
Enumeration date
01/28/2011
Last updated
06/10/2025
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