Organization
GREATER LOUISVILLE COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH L MCKENZIE (EXECUTIVE DIRECTOR)
(502) 587-9737
Entity
Organization
Contact information
Practice address
332 W BROADWAY, SUITE 905, LOUISVILLE, KY 40202-2130
(502) 587-9737
Mailing address
332 W BROADWAY, SUITE 905, LOUISVILLE, KY 40202-2130
(502) 587-9737
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
800150
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100323580
—
KY
Enumeration date
09/01/2015
Last updated
09/01/2015
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