Organization
AUGUSTINE HALL TRANSITIONAL LIVING CENTER
Active
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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