Provider Demographics
NPI:1649697640
Name:HOUSE OF RUTH, INC
Entity type:Organization
Organization Name:HOUSE OF RUTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:JD, MSSW
Authorized Official - Phone:502-587-5080
Mailing Address - Street 1:607 E SAINT CATHERINE ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-3409
Mailing Address - Country:US
Mailing Address - Phone:502-587-5080
Mailing Address - Fax:502-587-5009
Practice Address - Street 1:607 E SAINT CATHERINE ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-3409
Practice Address - Country:US
Practice Address - Phone:502-587-5080
Practice Address - Fax:502-587-5009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-27
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY01-160251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health