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Organization

GETTING BACK ON TRACK

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ADREANA M LOWERY (MEMBER)
(502) 677-9188
Entity
Organization

Contact information

Practice address
3135 W KENTUCKY ST, LOUISVILLE, KY 40211-1507
(502) 677-9188
Mailing address
3135 W KENTUCKY ST, LOUISVILLE, KY 40211-1507
(502) 677-9188

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
251S00000X
Community/Behavioral Health Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7101040620
KY
Enumeration date
10/24/2024
Last updated
05/23/2025
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