Provider Demographics
NPI:1255207973
Name:LILY OF HOPE PSYCHIATRY SERVICES
Entity type:Organization
Organization Name:LILY OF HOPE PSYCHIATRY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:OWEN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP-BC
Authorized Official - Phone:216-548-7202
Mailing Address - Street 1:3902 OLD BROWNSBORO HILLS RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-1637
Mailing Address - Country:US
Mailing Address - Phone:216-548-7202
Mailing Address - Fax:
Practice Address - Street 1:1313 LYNDON LN STE 211
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-7302
Practice Address - Country:US
Practice Address - Phone:216-549-7202
Practice Address - Fax:732-832-3732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty