| Living For A Change Support Services & Residence Llc | |
|
1439 S Brook St Apt 4 Louisville KY 40208-2043 | |
| (502) 684-1371 | |
| Not Available |
| Full Name | Living For A Change Support Services & Residence Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1439 S Brook St Apt 4, Louisville, Kentucky |
| Authorized Official Name and Position | Danielle Tucker (OWNER) |
| Authorized Official Contact | 5026841371 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Living For A Change Support Services & Residence Llc 1439 S Brook St Apt 4 Louisville KY 40208-2043 Ph: () - | Living For A Change Support Services & Residence Llc 1439 S Brook St Apt 4 Louisville KY 40208-2043 Ph: (502) 684-1371 |
| NPI Number | 1982319448 |
|---|---|
| Provider Enumeration Date | 01/19/2023 |
| Last Update Date | 01/19/2023 |
| Certification Date | 01/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982319448 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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