Organization
LITTLE GIRLS GROW UP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE SANDERS (CREDENTIALING AGENT)
(502) 630-2036
Entity
Organization
Contact information
Practice address
3407 W MUHAMMAD ALI BLVD, LOUISVILLE, KY 40212-2423
(502) 712-2802
Mailing address
3407 W MUHAMMAD ALI BLVD, LOUISVILLE, KY 40212-2423
(502) 712-2802
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/26/2024
Last updated
07/26/2024
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