Organization
KY MENTAL HEALTH SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE SANDERS (CREDENTIALING ADMIN)
(502) 630-2036
Entity
Organization
Contact information
Practice address
1010 CLARKS LN, LOUISVILLE, KY 40217-1510
(919) 827-6193
Mailing address
1010 CLARKS LN, LOUISVILLE, KY 40217-1510
(919) 827-6193
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
04/18/2023
Last updated
04/18/2023
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