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General NPI Number Information
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NPI Number | 1285597682
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Entity Type | Organization
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Legal Business Name | ANTOINETTE'S TCM SERVICES LLC
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1211 W BROADWAY
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City | LOUISVILLE
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State | KY
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Zip | 40203-2082
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Country | US
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Telephone | 502-975-9412
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Fax |
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Provider Business Mailing Address
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Address Line | 4621 OUTER LOOP STE 175
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City | LOUISVILLE
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State | KY
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Zip | 40219-3970
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Country | US
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Telephone | 502-975-9412
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Fax |
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Authorized Official
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Title or Position | TARGETED CASE MANAGER
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Name | ANTOINETTE MARTIN
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Credential | BA, TCM, TCADC
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Telephone | 502-975-9412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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