| Maryhurst, Inc. | |
|
1015 Dorsey Ln Louisville KY 40223-2612 | |
| (502) 245-1576 | |
| Not Available |
| Full Name | Maryhurst, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1015 Dorsey Ln, Louisville, Kentucky |
| Authorized Official Name and Position | Paula Garner (PRESIDENT/CEO) |
| Authorized Official Contact | 5022451576 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maryhurst, Inc. 1015 Dorsey Ln Louisville KY 40223-2612 Ph: (502) 245-1576 | Maryhurst, Inc. 1015 Dorsey Ln Louisville KY 40223-2612 Ph: (502) 245-1576 |
| NPI Number | 1851713614 |
|---|---|
| Provider Enumeration Date | 01/14/2014 |
| Last Update Date | 12/02/2022 |
| Certification Date | 12/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851713614 | NPI | - | NPPES |
| 7100326320 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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