| Restoration House | |
|
9319 Taylorsville Rd Louisville KY 40299-1737 | |
| (502) 618-1201 | |
| (502) 618-2609 |
| Full Name | Restoration House |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 9319 Taylorsville Rd, Louisville, Kentucky |
| Authorized Official Name and Position | Marydora Conley (CLINICAL PARTNER) |
| Authorized Official Contact | 5026181201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Restoration House 9319 Taylorsville Rd Louisville KY 40299-1737 Ph: (502) 618-1201 | Restoration House 9319 Taylorsville Rd Louisville KY 40299-1737 Ph: (502) 618-1201 |
| NPI Number | 1346431335 |
|---|---|
| Provider Enumeration Date | 08/06/2007 |
| Last Update Date | 12/23/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346431335 | NPI | - | NPPES |
| 1649473133 | Other | KY | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 1966 (Kentucky) | Primary |
| 106H00000X | Marriage & Family Therapist | 0575 (Kentucky) | Secondary |
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