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General NPI Number Information
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NPI Number | 1083182216
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Entity Type | Organization
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Legal Business Name | KENTUCKY MENTAL HEALTH CARE, L.L.C.
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Dates
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Enumeration Date | 11/06/2018
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 5115 S 3RD ST
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City | LOUISVILLE
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State | KY
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Zip | 40214-2601
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Country | US
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Telephone | 502-233-3030
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Fax | 502-719-8161
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Provider Business Mailing Address
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Address Line | 5115 S 3RD ST
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City | LOUISVILLE
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State | KY
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Zip | 40214-2601
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Country | US
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Telephone | 502-233-3030
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Fax | 502-719-8161
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Authorized Official
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Title or Position | CEO
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Name | JOSEPH NALLEY
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Credential |
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Telephone | 502-690-1511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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