Provider Demographics
NPI:1720703507
Name:LADIES & GENTLEMEN OF PROMISE INC
Entity Type:Organization
Organization Name:LADIES & GENTLEMEN OF PROMISE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-656-2429
Mailing Address - Street 1:1626 W CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-1608
Mailing Address - Country:US
Mailing Address - Phone:502-384-5807
Mailing Address - Fax:502-901-9070
Practice Address - Street 1:1626 W CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-1608
Practice Address - Country:US
Practice Address - Phone:502-384-5807
Practice Address - Fax:502-901-9070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility