Organization
4418 MALCOLM AVENUE OPS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA NEAL (MANAGER, CRED & CONTRACTING)
(629) 257-8260
Entity
Organization
Contact information
Practice address
4418 MALCOLM AVE, LOUISVILLE, KY 40215-1122
(502) 713-7017
(833) 792-1347
Mailing address
133 HOLIDAY CT STE 102, FRANKLIN, TN 37067-1386
(629) 257-8260
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/19/2024
Last updated
04/16/2026
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