Healthcare Provider Details

I. General information

NPI: 1457594830
Provider Name (Legal Business Name): BRENTWOOD MEADOWS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2009
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4488 ROSLIN RD
NEWBURGH IN
47630-8590
US

IV. Provider business mailing address

4801 OLYMPIA PARK PLZ STE 1000
LOUISVILLE KY
40241-2090
US

V. Phone/Fax

Practice location:
  • Phone: 812-858-7200
  • Fax:
Mailing address:
  • Phone: 502-916-8830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number StateIN

VIII. Authorized Official

Name: CHARLOTTE LAWRENCE
Title or Position: SECRETARY
Credential:
Phone: 615-920-7000