Provider Demographics
NPI:1134927403
Name:HALCYON KIZMET LLC
Entity type:Organization
Organization Name:HALCYON KIZMET LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SASSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-771-7444
Mailing Address - Street 1:PO BOX 809
Mailing Address - Street 2:
Mailing Address - City:CRESTWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:40014-0809
Mailing Address - Country:US
Mailing Address - Phone:859-771-7444
Mailing Address - Fax:502-237-7220
Practice Address - Street 1:2815 TAYLORSVILLE RD STE 102
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2100
Practice Address - Country:US
Practice Address - Phone:859-771-7444
Practice Address - Fax:502-237-7220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health