Provider Demographics
NPI:1467344135
Name:REFUGE FOR WOMEN - KENTUCKY LLC
Entity type:Organization
Organization Name:REFUGE FOR WOMEN - KENTUCKY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFIER
Authorized Official - Prefix:
Authorized Official - First Name:MARCIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-208-7050
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:WILMORE
Mailing Address - State:KY
Mailing Address - Zip Code:40390-0099
Mailing Address - Country:US
Mailing Address - Phone:502-208-7050
Mailing Address - Fax:
Practice Address - Street 1:9312 NEW LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40242-3619
Practice Address - Country:US
Practice Address - Phone:502-208-7050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty