Organization
SAGE SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK NEESE (MEMBER)
(502) 435-9226
Entity
Organization
Contact information
Practice address
11121 BLADE CREST WAY, LOUISVILLE, KY 40291-5076
(502) 435-9226
Mailing address
11121 BLADE CREST WAY, LOUISVILLE, KY 40291-5076
(502) 435-9226
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
10/30/2012
Last updated
05/21/2019
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