Organization
EVOLVE COMMUNITY CONSULTING
Active
Other names
The Body Vault LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MIAUNA KINNARD (CASE MANAGER/PROGRAM COORDINATOR)
(502) 712-7443
Entity
Organization
Contact information
Practice address
3423 STONY SPRING CIR, LOUISVILLE, KY 40220-5437
(502) 709-9589
Mailing address
3423 STONY SPRING CIR, LOUISVILLE, KY 40220-5437
(502) 709-9589
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251B00000X
Case Management Agency
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
03/20/2024
Last updated
01/13/2026
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