Organization
PRODIGAL SON LIFE BUILDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANAE DICKERSON (MANAGER)
(804) 605-5318
Entity
Organization
Contact information
Practice address
1154 S 15TH ST, LOUISVILLE, KY 40210-1567
(804) 605-5318
Mailing address
1154 S 15TH ST, LOUISVILLE, KY 40210-1567
(804) 605-5318
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/18/2025
Last updated
04/17/2026
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