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General NPI Number Information
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NPI Number | 1306667787
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Entity Type | Organization
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Legal Business Name | LOUCAR HOUSE INCORPORATED
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Dates
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Enumeration Date | 10/18/2024
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 314 S WENZEL ST
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City | LOUISVILLE
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State | KY
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Zip | 40204-1047
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Country | US
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Telephone | 502-387-1228
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Fax |
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Provider Business Mailing Address
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Address Line | 3772 STANTON BLVD
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City | LOUISVILLE
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State | KY
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Zip | 40220-1963
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Country | US
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Telephone | 502-387-1228
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PROF. LISA DAVIS GLENN
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Credential |
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Telephone | 502-387-1228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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