CLEANSE CLINIC PSC NPI 1659726628

NPI Information

CLEANSE CLINIC, PSC is an addiction psychiatry psychiatry neurology in Louisville, KY. The provider is addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders. CLEANSE CLINIC, PSC NPI is 1659726628. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9720 PARK PLAZA AVE
SUITE 104
LOUISVILLE, KY
ZIP 40241-288
Phone: (502) 938-0511
Fax: (502) 371-6110

The provider's authorized official is Margaret Groll .
The authorized official title is Business Manager and has the following contact phone number (502) 561-0943.

The CLIA number assigned to this NPI record is 18D2120455 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 4/27/2016 and was last updated on 11/17/2016.

Taxonomy Codes

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Other Identifiers

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