Organization
TIME TO LEVEL UP TRANSITIONAL HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE SANDERS (CREDENTIALING)
(502) 630-2036
Entity
Organization
Contact information
Practice address
1790 WATHEN LN, LOUISVILLE, KY 40216-5147
(502) 351-9047
Mailing address
1790 WATHEN LN, LOUISVILLE, KY 40216-5147
(502) 351-9047
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/13/2024
Last updated
02/13/2024
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