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Organization

BOSS RECOVERY SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NASIRA MAH-JABEEN (CREDENTIALING AGENT)
(150) 257-9017
Entity
Organization

Contact information

Practice address
2600 W BROADWAY STE 318, LOUISVILLE, KY 40211-1366
(440) 444-8302
Mailing address
2600 W BROADWAY STE 318, LOUISVILLE, KY 40211-1366

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Enumeration date
09/25/2023
Last updated
09/25/2023
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