Organization
LOUISVILLE JEFFERSON COUNTY METRO GOVERNMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVETTE DENISE HUDSON (FISCAL MANAGER)
(502) 574-6580
Entity
Organization
Contact information
Practice address
4500 CHURCHMAN AVE, LOUISVILLE, KY 40215-1188
(502) 574-6414
Mailing address
611 W JEFFERSON ST, LOUISVILLE, KY 40202-2743
(502) 574-6580
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100589030
—
KY
Enumeration date
10/30/2014
Last updated
04/28/2020
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