Provider Demographics
NPI:1851884662
Name:KENTUCKY HEALTH PARTNERS, LLC
Entity Type:Organization
Organization Name:KENTUCKY HEALTH PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SELESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:336-399-2889
Mailing Address - Street 1:4365 IRIS BROOKE LN
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-8426
Mailing Address - Country:US
Mailing Address - Phone:502-561-3459
Mailing Address - Fax:502-561-3444
Practice Address - Street 1:101 N 7TH ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-2924
Practice Address - Country:US
Practice Address - Phone:502-561-3459
Practice Address - Fax:502-561-3444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health