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Organization

FACES OF CHANGE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JACQUELINE SANDERS (MANAGER)
(502) 630-2036
Entity
Organization

Contact information

Practice address
2809 W MARKET ST, LOUISVILLE, KY 40212-1846
(502) 303-7665
(502) 632-1432
Mailing address
2809 W MARKET ST, LOUISVILLE, KY 40212-1846
(502) 303-7665
(502) 632-1432

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
251S00000X
TAXONOMY
KY
Enumeration date
09/11/2021
Last updated
09/11/2021
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