Organization
MYLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN SCOTT BYRNE (PRESIDENT)
(502) 640-1669
Entity
Organization
Contact information
Practice address
1868 CAMPUS PL, LOUISVILLE, KY 40299-2305
(502) 640-1669
Mailing address
1868 CAMPUS PL, LOUISVILLE, KY 40299-2305
(502) 640-1669
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251F00000X
Home Infusion Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
09/12/2014
Last updated
12/04/2014
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