Provider Demographics
NPI:1033351010
Name:PATH FORWARD OF KENTUCKY INC.
Entity Type:Organization
Organization Name:PATH FORWARD OF KENTUCKY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOLTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-338-1176
Mailing Address - Street 1:707 EXECUTIVE PARK
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4207
Mailing Address - Country:US
Mailing Address - Phone:502-451-2565
Mailing Address - Fax:502-451-2732
Practice Address - Street 1:707 EXECUTIVE PARK
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4207
Practice Address - Country:US
Practice Address - Phone:502-451-2565
Practice Address - Fax:502-451-2732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 251K00000X, 251S00000X, 261QM1300X
KY251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty