Organization
PENNYROYAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA R WOOD (PRIMARY SERVICE COORDINATOR)
(270) 338-5211
Entity
Organization
Contact information
Practice address
5121 EMERY AVE, LOUISVILLE, KY 40214-2724
(502) 693-3437
Mailing address
5121 EMERY AVE, LOUISVILLE, KY 40214-2724
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
08/18/2009
Last updated
08/18/2009
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