Organization
CAN-TEENS FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DELORES JORDAN (OWNER)
(704) 999-8627
Entity
Organization
Contact information
Practice address
800 CAWTHORN ST, LOUISVILLE, KY 40203
(704) 891-6883
Mailing address
800 CAWTHORN ST, LOUISVILLE, KY 40203
(704) 891-6883
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/05/2021
Last updated
10/05/2021
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