Provider Demographics
NPI: | 1326500059 |
---|---|
Name: | APPLEGATE HEALTH SERVICES, INC |
Entity Type: | Organization |
Organization Name: | APPLEGATE HEALTH SERVICES, INC |
Other - Org Name: | APPLEGATE RECOVERY LOUISVILLE |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | VP |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MICHAEL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SAUL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 214-379-3300 |
Mailing Address - Street 1: | 1720 LAKEPOINTE DR STE 117 |
Mailing Address - Street 2: | |
Mailing Address - City: | LEWISVILLE |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75057-6425 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 214-379-3300 |
Mailing Address - Fax: | 214-853-9018 |
Practice Address - Street 1: | 11518 MAIN ST |
Practice Address - Street 2: | |
Practice Address - City: | MIDDLETOWN |
Practice Address - State: | KY |
Practice Address - Zip Code: | 40243-1316 |
Practice Address - Country: | US |
Practice Address - Phone: | 502-445-6325 |
Practice Address - Fax: | 502-253-4672 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-04-02 |
Last Update Date: | 2024-02-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |