Individual
LATISHA L LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4521 SHELVIS DR, LOUISVILLE, KY 40216-3072
(502) 387-5015
Mailing address
4521 SHELVIS DR, LOUISVILLE, KY 40216-3072
(502) 387-5015
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
252686
KY
Other
Enumeration date
02/13/2026
Last updated
02/13/2026
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