| Phc-cleveland Llc | |
|
680 S 4th St Louisville KY 40202-2407 | |
| (502) 596-6063 | |
| (502) 212-8481 |
| Full Name | Phc-cleveland Llc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 680 S 4th St, Louisville, Kentucky |
| Authorized Official Name and Position | Johnetta Traylor (DIRECTOR) |
| Authorized Official Contact | 5025966063 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phc-cleveland Llc 680 S 4th St Louisville KY 40202-2407 Ph: () - | Phc-cleveland Llc 680 S 4th St Louisville KY 40202-2407 Ph: (502) 596-6063 |
| NPI Number | 1306142062 |
|---|---|
| Provider Enumeration Date | 01/28/2011 |
| Last Update Date | 06/10/2025 |
| Certification Date | 06/10/2025 |
| Medicare PECOS PAC ID | 6608848270 |
|---|---|
| Medicare Enrollment ID | O20110223000397 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306142062 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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