| Willenium Enterprise Foundation | |
|
3401 Dixie Hwy Louisville KY 40216-5015 | |
| (502) 615-6542 | |
| (502) 331-6062 |
| Full Name | Willenium Enterprise Foundation |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3401 Dixie Hwy, Louisville, Kentucky |
| Authorized Official Name and Position | Nakristia Pitts (OWNER) |
| Authorized Official Contact | 5026156542 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Willenium Enterprise Foundation 6915 Rock Hollow Dr Louisville KY 40219-2416 Ph: (502) 615-6542 | Willenium Enterprise Foundation 3401 Dixie Hwy Louisville KY 40216-5015 Ph: (502) 615-6542 |
| NPI Number | 1578339271 |
|---|---|
| Provider Enumeration Date | 12/04/2023 |
| Last Update Date | 12/04/2023 |
| Certification Date | 12/04/2023 |
| Medicare PECOS PAC ID | 2466890009 |
|---|---|
| Medicare Enrollment ID | O20240402002939 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578339271 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Nakrista A Pitts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962972810 PECOS PAC ID: 1052644580 Enrollment ID: I20190614001009 |
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