Organization
A VISION FOR YOU INC
Active
Other names
The Surrender Program, Chase M Daub Center, MindBodySoul IOP/OP
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHNATHAN LUCAS BENNETT CADCA I (PRESIDENT & EXECUTIVE DIRECTOR)
(502) 749-6344
Entity
Organization
Contact information
Practice address
1675 STORY AVE, LOUISVILLE, KY 40206-1739
(502) 749-6344
Mailing address
1675 STORY AVE, LOUISVILLE, KY 40206-1739
(502) 749-6344
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
177F00000X
Lodging Provider
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
811959
KENTUCKY CABINET FOR HEALTH AND FAMILY SERVICES - AODE
KY
Enumeration date
12/28/2023
Last updated
01/15/2026
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