Provider Demographics
NPI:1497156822
Name:ST. JOSEPH CATHOLIC ORPHAN'S SOCIETY
Entity Type:Organization
Organization Name:ST. JOSEPH CATHOLIC ORPHAN'S SOCIETY
Other - Org Name:ST. JOSEPH CHILDREN'S HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GREENWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-893-0241
Mailing Address - Street 1:2823 FRANKFORT AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-2639
Mailing Address - Country:US
Mailing Address - Phone:502-893-0241
Mailing Address - Fax:502-896-2394
Practice Address - Street 1:2823 FRANKFORT AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-2639
Practice Address - Country:US
Practice Address - Phone:502-893-0241
Practice Address - Fax:502-896-2394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-04
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0850X, 261QM0855X
KY500043322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children