| Creative Spirits Llc | |
|
12730 Townepark Way Louisville KY 40243-2303 | |
| (502) 254-9555 | |
| (502) 254-9554 |
| Full Name | Creative Spirits Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 12730 Townepark Way, Louisville, Kentucky |
| Authorized Official Name and Position | Cassandra D Harris-gray (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5022549555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Spirits Llc 12730 Townepark Way Louisville KY 40243-2303 Ph: (502) 254-9555 | Creative Spirits Llc 12730 Townepark Way Louisville KY 40243-2303 Ph: (502) 254-9555 |
| NPI Number | 1194170266 |
|---|---|
| Provider Enumeration Date | 04/26/2016 |
| Last Update Date | 04/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194170266 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 800216 (Kentucky) | Primary |
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