Healthcare Provider Details

I. General information

NPI: 1770906646
Provider Name (Legal Business Name): USPIRITUS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2014
Last Update Date: 01/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3121 BROOKLAWN CAMPUS DR
LOUISVILLE KY
40218-1282
US

IV. Provider business mailing address

3121 BROOKLAWN CAMPUS DR
LOUISVILLE KY
40218-1282
US

V. Phone/Fax

Practice location:
  • Phone: 502-451-5177
  • Fax: 502-451-0896
Mailing address:
  • Phone: 502-451-5177
  • Fax: 502-451-0896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. MARY-KATE O'LEARY
Title or Position: PRESIDENT/C.E.O.
Credential: MA
Phone: 502-451-5177