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NPI Code Detail

MEDICARE: ST. JOSEPH CATHOLIC ORPHAN'S SOCIETY

MEDICARE: ST. JOSEPH CATHOLIC ORPHAN'S SOCIETY
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
1261QM0850XAdult Mental Health Clinic/Center
2322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility500043KY
3261QM0855XAdolescent and Children Mental Health Clinic/Center

General Provider Information

NPI Number : 1497156822
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST. JOSEPH CATHOLIC ORPHAN'S SOCIETY
Provider Business Mailing Address
First Line : 2823 FRANKFORT AVE
Second Line :
City : LOUISVILLE
State : KY
Zip : 40206-2639
Country : US
Telephone Number : 502-893-0241
Fax Number : 502-896-2394
Provider Business Practice Location Address
First Line : 2823 FRANKFORT AVE
Second Line :
City : LOUISVILLE
State : KY
Zip : 40206-2639
Country : US
Telephone Number : 502-893-0241
Fax Number : 502-896-2394
Authorized Official
Title or Position : COO
Name : JULIE MARIE GREENWELL
Credential :
Telephone Number : 502-893-0241
Provider Enumeration Date : 09/04/2014
Last Update Date : 10/26/2023

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