4112 Fern Valley Road Ops LLC
Organization Active NPI Substance Abuse Rehabilitation Facility · Louisville, KY
NPI 1124862750 · NPPES record last updated Jun 19, 2024
Key facts
- NPI
- 1124862750
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Abuse Rehabilitation Facility 324500000X
- Legal business name
- 4112 FERN VALLEY ROAD OPS LLC
- Practice address
- 4112 Fern Valley Rd
Louisville, KY 40219-1973 - Phone
- (502) 964-2699
- Fax
- (833) 728-0420
- NPI assigned
- Jun 19, 2024
- Organization subpart
- No
Authorized official
- Name
- Alicia Neal
- Title
- Manager, Cred & Contracting
- Phone
- (615) 281-9050
National Provider Directory
Locations
4112 Fern Valley Rd
Louisville, KY 40219
Phone (502) 221-3932
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | Yes |
Addresses
Primary practice location
4112 Fern Valley Rd
Louisville, KY 40219-1973
Mailing address
133 Holiday CT Ste 102
Franklin, TN 37067-1386
Phone (615) 281-9050
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.