Provider Demographics
NPI:1699822338
Name:LOUISVILLE CENTER FOR ADULT CHILDREN, INC.
Entity Type:Organization
Organization Name:LOUISVILLE CENTER FOR ADULT CHILDREN, INC.
Other - Org Name:VISIONARYPATHWAYS COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:502-458-5277
Mailing Address - Street 1:1562 BARDSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-1155
Mailing Address - Country:US
Mailing Address - Phone:502-458-5277
Mailing Address - Fax:502-459-6769
Practice Address - Street 1:1562 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-1155
Practice Address - Country:US
Practice Address - Phone:502-458-5277
Practice Address - Fax:502-459-6769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health