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General NPI Number Information
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NPI Number | 1255200804
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Entity Type | Organization
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Legal Business Name | ATHENA HEALTH KY LLC
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 2515 7TH STREET RD STE 2
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City | LOUISVILLE
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State | KY
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Zip | 40208-1070
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Country | US
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Telephone | 502-281-7697
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Fax | 502-234-1973
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Provider Business Mailing Address
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Address Line | 2515 7TH STREET RD STE 2
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City | LOUISVILLE
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State | KY
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Zip | 40208-1070
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Country | US
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Telephone | 502-281-7697
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Fax | 502-234-1973
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Authorized Official
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Title or Position | CEO
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Name | ANGELETE MORELAND
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Credential |
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Telephone | 502-804-8003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 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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