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NPI Code Detail

MEDICARE: SPRINGHEALTH BEHAVIORAL HEALTH AND INTEGRATED CARE KENTUCKY, LLC

MEDICARE: SPRINGHEALTH BEHAVIORAL HEALTH AND INTEGRATED CARE KENTUCKY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1326569401
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPRINGHEALTH BEHAVIORAL HEALTH AND INTEGRATED CARE KENTUCKY, LLC
Provider Business Mailing Address
First Line : 805 N WHITTINGTON PKWY STE 400
Second Line :
City : LOUISVILLE
State : KY
Zip : 40222-5186
Country : US
Telephone Number : 502-297-0133
Fax Number : 502-297-0289
Provider Business Practice Location Address
First Line : 11401 BLUEGRASS PKWY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40299-2349
Country : US
Telephone Number : 502-297-0133
Fax Number : 502-297-0289
Authorized Official
Title or Position : PARALEGAL
Name : MARY A PANK
Credential :
Telephone Number : 502-420-2666
Provider Enumeration Date : 06/29/2017
Last Update Date : 04/11/2019

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