| Rebirth & Renewal Family Resource Center Llc | |
|
2900 W Broadway Ste 4 Louisville KY 40211-1281 | |
| (502) 592-2009 | |
| Not Available |
| Full Name | Rebirth & Renewal Family Resource Center Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2900 W Broadway Ste 4, Louisville, Kentucky |
| Authorized Official Name and Position | Sandra Marshall-king (OWNER) |
| Authorized Official Contact | 5025922009 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rebirth & Renewal Family Resource Center Llc 2900 W Broadway Ste 4 Louisville KY 40211-1281 Ph: (502) 592-2009 | Rebirth & Renewal Family Resource Center Llc 2900 W Broadway Ste 4 Louisville KY 40211-1281 Ph: (502) 592-2009 |
| NPI Number | 1073090874 |
|---|---|
| Provider Enumeration Date | 07/24/2018 |
| Last Update Date | 02/26/2022 |
| Certification Date | 02/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073090874 | NPI | - | NPPES |
| 7100542650 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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