Organization
KMI ACQUISITION LLC
Active
Other names
The Brook Hospital KMI
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE FILTON (SR VP CFO)
(610) 768-3300
Entity
Organization
Contact information
Practice address
8521 LAGRANGE RD, LOUISVILLE, KY 40242-3800
(502) 426-6380
(502) 814-3711
Mailing address
8521 LAGRANGE RD, LOUISVILLE, KY 40242-3800
(502) 426-6380
(502) 814-3711
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25460
KY
283Q00000X
Psychiatric Hospital
Primary
100241
KY
323P00000X
Psychiatric Residential Treatment Facility
100241
KY
324500000X
Substance Abuse Rehabilitation Facility
810229
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000054468
BC/BS PROVIDER NUMBER
KY
01
—
000000321602
ANTHEM PROFESSIONAL
KY
01
—
008618000
MAGELLAN BEHAVIORAL HEALT
KY
05
—
02021210
—
KY
05
—
100038830A
—
IN
05
—
2361377
—
OH
05
—
2685173000
—
KY
05
—
45027190
—
KY
05
—
50005909
—
KY
Enumeration date
09/15/2005
Last updated
01/14/2014
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