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Organization

AUGUSTINE HALL TRANSITIONAL LIVING CENTER

Active
Parent organization
GREATER LOUISVILLE COUNSELING CENTER
Organization subpart
Yes

Provider details

NPI number
Legal business name
GREATER LOUISVILLE COUNSELING CENTER
Authorized official
KEITH MCKENZIE (EXECUTIVE DIRECTOR)
(502) 587-9737
Entity
Organization

Contact information

Practice address
1455 S PRESTON ST, SUITE 905, LOUISVILLE, KY 40208-2717
(502) 587-9737
Mailing address
1455 S PRESTON ST, SUITE 905, LOUISVILLE, KY 40208-2717
(502) 587-9737

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
810479
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100323580
KY
Enumeration date
06/28/2016
Last updated
06/28/2016
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