Organization
PAX HOUSE INC.
Active
Parent organization
PAX HOUSE INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PAX HOUSE INC.
Authorized official
MR. JORDAN T. DESIMONE CADC-CAS (PROGRAM DIRECTOR)
(626) 808-0335
Entity
Organization
Contact information
Practice address
2305 HURSTBOURNE VILLAGE DR STE 600, LOUISVILLE, KY 40299-2875
(626) 840-0111
(626) 270-4640
Mailing address
2305 HURSTBOURNE VILLAGE DR STE 600, LOUISVILLE, KY 40299-2875
(626) 840-0111
(626) 270-4640
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
09/11/2018
Last updated
09/11/2018
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