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Organization

2022 LLC

Active
Parent organization
2022 LLC
Other names
Arch to Freedom Recovery Center, DBA Arch Medical Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
2022 LLC
Authorized official
XAVIER GILES (OWNER)
(502) 384-0939
Entity
Organization

Contact information

Practice address
700 GAGEL AVE, LOUISVILLE, KY 40216-4008
(502) 963-5516
(502) 963-5704
Mailing address
4104 SMARTY JONES DR, LOUISVILLE, KY 40214-6530
(502) 759-6281
(502) 772-1533

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
363LP2300X
Primary Care Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7101036390
KY
Enumeration date
01/16/2025
Last updated
10/03/2025
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