Provider Demographics
NPI:1326406588
Name:NORMAL LIFE FAMILY SERVICES, INC.
Entity Type:Organization
Organization Name:NORMAL LIFE FAMILY SERVICES, INC.
Other - Org Name:WAIVER OPERATIONS
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSOC. GEN. COUNSEL
Authorized Official - Prefix:MS
Authorized Official - First Name:DEENA
Authorized Official - Middle Name:G
Authorized Official - Last Name:OMBRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-394-2100
Mailing Address - Street 1:9901 LINN STATION RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-3808
Mailing Address - Country:US
Mailing Address - Phone:502-394-2100
Mailing Address - Fax:
Practice Address - Street 1:2895 HIGHWAY 190
Practice Address - Street 2:SUITE A1 - 2
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-3414
Practice Address - Country:US
Practice Address - Phone:985-674-4177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health