Provider Demographics
NPI:1952007569
Name:LOUISVILLE CENTER FOR THERAPY AND PERSONAL SUSTAINABILITY
Entity Type:Organization
Organization Name:LOUISVILLE CENTER FOR THERAPY AND PERSONAL SUSTAINABILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:FARSETTI
Authorized Official - Suffix:
Authorized Official - Credentials:MT-BC
Authorized Official - Phone:502-418-2089
Mailing Address - Street 1:1010 E BRECKINRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40204-1854
Mailing Address - Country:US
Mailing Address - Phone:502-418-2089
Mailing Address - Fax:
Practice Address - Street 1:1974 DOUGLASS BLVD STE 8
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-1826
Practice Address - Country:US
Practice Address - Phone:502-694-0919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health