Provider Demographics
NPI:1669003372
Name:CRIMSON DOVE COUNSELING SERVICES INC
Entity Type:Organization
Organization Name:CRIMSON DOVE COUNSELING SERVICES INC
Other - Org Name:CRIMSON DOVE ABI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-742-4014
Mailing Address - Street 1:214 BRECKENRIDGE LN STE 205
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3879
Mailing Address - Country:US
Mailing Address - Phone:502-742-4014
Mailing Address - Fax:502-709-4264
Practice Address - Street 1:214 BRECKENRIDGE LN STE 203
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3879
Practice Address - Country:US
Practice Address - Phone:502-742-4014
Practice Address - Fax:502-709-4264
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRIMSON DOVE COUNSELING SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-31
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home