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General NPI Number Information
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NPI Number | 1982079059
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Entity Type | Organization
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Legal Business Name | A GREATER ALTERNATIVE INC
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Dates
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Enumeration Date | 12/01/2015
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Last Update Date | 12/01/2015
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Provider Practice Location Address
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Address Line | 1169 EASTERN PKWY SUITE 1138
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City | LOUISVILLE
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State | KY
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Zip | 40217-1417
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Country | US
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Telephone | 502-454-6350
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Fax | 502-454-6351
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Provider Business Mailing Address
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Address Line | 1169 EASTERN PKWY SUITE 1138
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City | LOUISVILLE
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State | KY
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Zip | 40217-1417
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Country | US
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Telephone | 502-454-6350
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Fax | 502-454-6351
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. LESLIE GREATER
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Credential | BSW
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Telephone | 502-454-6350
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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 | ADCADC00194202
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License Number State | KY
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