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Organization

YMCA OF GREATER LOUISVILLE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. STEPHEN TARVER (PRESIDENT AND CEO)
(502) 587-9622
Entity
Organization

Contact information

Practice address
2800 FORDHAVEN RD, LOUISVILLE, KY 40214-3960
(502) 933-9622
(502) 933-6309
Mailing address
545 S 2ND ST, LOUISVILLE, KY 40202-1801
(502) 587-9622
(502) 587-4323

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
750124
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43000280
KY
05
56023898
KY
05
56025018
KY
Enumeration date
01/04/2007
Last updated
06/30/2008
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