Healthcare Provider Details

I. General information

NPI: 1801585252
Provider Name (Legal Business Name): USPIRITUS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2023
Last Update Date: 05/02/2023
Certification Date: 04/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 GOLDSMITH LANE
LOUISVILLE KY
40218
US

IV. Provider business mailing address

10401 LINN STATION RD STE 100
LOUISVILLE KY
40223-3842
US

V. Phone/Fax

Practice location:
  • Phone: 502-589-8600
  • Fax:
Mailing address:
  • Phone: 502-589-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ABBREIAL DRANE
Title or Position: PRESIDENT CEO
Credential:
Phone: 502-589-8600