Organization
ALTERNATIVE YOUTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE MATTINGLY (MANAGER-PROVIDER ENROLLMENT)
(502) 381-3579
Entity
Organization
Contact information
Practice address
11218 PROFESSIONAL PARK DR, LOUISVILLE, KY 40291-4476
(502) 239-4959
Mailing address
805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/28/2020
Last updated
05/28/2020
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