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General NPI Number Information
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NPI Number | 1164242491
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Entity Type | Organization
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Legal Business Name | WOMEN OF WORTH TRANSITIONAL AND FINISHING CENTER, INC.
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 310 W LANSING AVE
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City | LOUISVILLE
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State | KY
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Zip | 40214-1514
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Country | US
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Telephone | 502-819-7863
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Fax |
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Provider Business Mailing Address
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Address Line | 8302 CLOVERPORT DR
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City | LOUISVILLE
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State | KY
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Zip | 40228-2340
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Country | US
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Telephone | 502-819-7863
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER/VICE PRESIDENT
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Name | MRS. WANDA M. FAWBUSH
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Credential |
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Telephone | 502-819-7863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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