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General NPI Number Information
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NPI Number | 1083430029
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Entity Type | Organization
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Legal Business Name | THE HEALING COTTAGE
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 813 HAZEL ST
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City | LOUISVILLE
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State | KY
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Zip | 40211-1430
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Country | US
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Telephone | 502-994-9245
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Fax |
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Provider Business Mailing Address
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Address Line | 813 HAZEL ST
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City | LOUISVILLE
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State | KY
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Zip | 40211-1430
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Country | US
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Telephone | 502-994-9245
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DION WASHINGTON SR.
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Credential |
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Telephone | 502-221-1075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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License Number |
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License Number State |
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