| Livewise Llc | |
|
103 Englewood Dr Bardstown KY 40004-2520 | |
| (502) 510-3630 | |
| Not Available |
| Full Name | Livewise Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 103 Englewood Dr, Bardstown, Kentucky |
| Authorized Official Name and Position | Jay Anthony Hall (OWNER) |
| Authorized Official Contact | 5025103630 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Livewise Llc 103 Englewood Dr Bardstown KY 40004-2520 Ph: (502) 510-3630 | Livewise Llc 103 Englewood Dr Bardstown KY 40004-2520 Ph: (502) 510-3630 |
| NPI Number | 1225395023 |
|---|---|
| Provider Enumeration Date | 04/18/2012 |
| Last Update Date | 04/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225395023 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | KY-1412 (Kentucky) | Primary |
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