Organization
LIFEWORKS OF KENTUCKY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK T FREESE (CEO)
(502) 416-1968
Entity
Organization
Contact information
Practice address
1868 CAMPUS PL, LOUISVILLE, KY 40299-2305
(502) 416-1968
Mailing address
1868 CAMPUS PL, LOUISVILLE, KY 40299-2305
(502) 416-1968
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/24/2010
Last updated
11/24/2010
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