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General NPI Number Information
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NPI Number | 1124687132
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Entity Type | Organization
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Legal Business Name | MENDED BEHAVIORAL & MENTAL HEALTH SERVICES
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Dates
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Enumeration Date | 06/12/2019
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 4229 BARDSTOWN RD STE 320
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City | LOUISVILLE
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State | KY
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Zip | 40218-3275
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Country | US
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Telephone | 502-883-0027
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Fax |
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Provider Business Mailing Address
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Address Line | 6407 BARDSTOWN RD # 257
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City | LOUISVILLE
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State | KY
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Zip | 40291-3040
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Country | US
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Telephone | 502-407-7890
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WASHEENER BARBER
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Credential | LPCC-S
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Telephone | 502-407-7890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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