Organization
NEXT STEPS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD PETTUS (CEO)
(502) 472-6790
Entity
Organization
Contact information
Practice address
1626 W CHESTNUT ST, LOUISVILLE, KY 40203-1608
(502) 472-6790
Mailing address
1626 W CHESTNUT ST, LOUISVILLE, KY 40203-1608
(502) 472-6790
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
175T00000X
Peer Specialist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
05/07/2026
Last updated
08/24/2026
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