Organization
2022 LLC
Active
Other names
Arch to Freedom Recovery Center
Organization subpart
No
Provider details
NPI number
Authorized official
XAVIER GILES (OWNER)
(502) 384-0939
Entity
Organization
Contact information
Practice address
1229 ARCADE AVE, LOUISVILLE, KY 40215-2203
(502) 384-0939
(502) 384-6008
Mailing address
4104 SMARTY JONES DR, LOUISVILLE, KY 40214-6530
(502) 759-6281
(502) 772-1533
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100994100
—
KY
Enumeration date
07/10/2024
Last updated
05/30/2025
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