Organization
PROFESSIONAL ADVOCACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELINE SANDERS (CREDENTIALING ADMN)
(502) 200-3550
Entity
Organization
Contact information
Practice address
4120 BISHOP LN, LOUISVILLE, KY 40218-4504
(661) 388-9846
Mailing address
2120 3RD AVE, LOS ANGELES, CA 90018-1226
(888) 382-2016
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
07/08/2021
Last updated
03/26/2025
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