Healthcare Provider Details
I. General information
NPI: 1346466372
Provider Name (Legal Business Name): VISUALLY IMPAIRED PRESCHOOLERS SERVICES OF GREATER LOUISVILLE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1906 GOLDSMITH LN
LOUISVILLE KY
40218-2066
US
IV. Provider business mailing address
1906 GOLDSMITH LN
LOUISVILLE KY
40218-2066
US
V. Phone/Fax
- Phone: 502-636-3207
- Fax:
- Phone: 502-636-3207
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | KY |
VIII. Authorized Official
Name:
MELINDA
ATKINS
Title or Position: EDUCATION COORDINATOR
Credential: MED
Phone: 502-636-3207