LANDMARK RECOVERY OUTPATIENT SERVICES LLC (NPI# 1063999761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063999761 |
| Entity Type | Organization |
| Organization Name | LANDMARK RECOVERY OUTPATIENT SERVICES LLC |
| Practice Address |
4112 Fern Valley Rd Ste B Louisville KY 40219-1973 |
| Mailing Address |
4835 E Cactus Rd Ste 130 Scottsdale AZ 85254-3545 |
| Practice Telephone | 5022213932 |
| Practice Fax Number | 5029642682 |
| Mailing Telephone | 4805512163 |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2019-04-30 |
| Authorized Official Name | NICHOLAS JAMES LOSOLE (PRESIDENT, OUTPATIENT SERVICES) |
| Authorized Official Telephone | 4805502163 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | LICENSE | 800286 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4419 La Salle Avenue, Louisville, KY 40215 | 8884480302 | |
| 1510 Newtown Pike Ste 120, Lexington, KY 405111255 | 8884480302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972075844 | Landmark Recovery Outpatient Services LLC | Clinic/Center | 1510 Newtown Pike Ste 120, Lexington, KY 40511-1255 | 2018-12-17 |
| Street Address |
4112 FERN VALLEY RD STE B |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40219-1973 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255948154 | Kathleen B Berghausen | Nurse Practitioner | 4112 Fern Valley Rod, Louisville, KY 40219 | 2020-09-25 |
| 1174165989 | Joann Deborah Hobbs | Nurse Practitioner | 8216 Delido Rd, Louisville, KY 40219 | 2019-10-14 |
| 1962989319 | Jennifer Lynn Pinkerton | Hearing Instrument Specialist | 7326 Preston Hwy, Suite 206a, Louisville, KY 40219 | 2018-07-27 |
| 1942748447 | Melissa Freeman Emanuele | Speech-Language Pathologist | 1550 Raydale Drive, Lousville, KY 40219 | 2017-02-03 |
| 1083014013 | Christopher Maxey | Specialist/Technologist | Fern Valley Rd, Louisville, KY 40219 | 2014-08-27 |
| 1679985949 | Antwan Turner | Case Manager/Care Coordinator | 5523 Saxon Blvd, Louisville, KY 40219 | 2014-05-21 |
| 1386055168 | Kelly Larson | Case Manager/Care Coordinator | 6809 Bebe Ct., Louisville, KY 40219 | 2014-05-14 |
| 1639414626 | Prettysmilesdenturesandmorellc | Dentist | 19123 West Mcnichols Rd, Detroit, MI 40219 | 2012-12-03 |
| 1881967701 | Vickie Lynn Dixon | Homemaker | 3516 Templewood Dr., Louisville, KY 40219 | 2012-02-23 |
| 1811157555 | Tonya Lynn Frost | Chiropractor | 4300 Outer Loop Ste 10, Louisville, KY 40219 | 2008-06-16 |
| Find all providers in zip 40219 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1619450186 | Pax House Inc. | Clinic/Center | 2305 Hurstbourne Village Dr Ste 600, Louisville, KY 40299-2875 | 2018-09-11 |
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| 1447858642 | Salem Health Care Group LLC | Clinic/Center | 501 North Hayden Avenue, Salem, KY 42028 | 2020-10-12 |
| 1053934836 | Roaring Brook LLC | Clinic/Center | 600 Perimeter Dr Ste 125, Lexington, KY 40517-4296 | 2020-05-27 |
| 1902442585 | Lake Cumberland Recovery, Inc | Clinic/Center | 8294 S Highway 27, Burnside, KY 42519-9412 | 2019-11-19 |
| 1073075792 | Applegate Health Services, Inc | Clinic/Center | 5966 Scottsville Road Unit 7, Bowling Green, KY 42104 | 2019-04-02 |
| 1194295089 | Freedom Bridge To Recovery LLC | Clinic/Center | 1307 Magnolia St, Bowling Green, KY 42104-3050 | 2018-12-04 |
| 1144723453 | Rose of Sharon House | Clinic/Center | 865 W Shelby St, Junction City, KY 40440-8502 | 2018-03-13 |
| 1477062487 | New Legacy Recovery LLC | Clinic/Center | 1510 Newtown Pike Ste 120, Lexington, KY 40511-1255 | 2017-09-21 |
| 1710426960 | The Liberty Ranch Rehabilitation Center | Clinic/Center | 2735 Ky Highway 501, Kings Mountain, KY 40442-9761 | 2017-02-21 |
| 1114389822 | Pinnacle Treatment Centers Ky-i, LLC | Clinic/Center | 100 E Broadway # 105-107, Mayfield, KY 42066-2329 | 2016-03-22 |
| 1306215470 | Stepworks Recovery Centers LLC | Clinic/Center | 210 Malabu Dr Ste 200, Lexington, KY 40502-3215 | 2015-09-18 |
| Find all providers with the same taxonomy | ||||
| City | LOUISVILLE |
| Zip Code | 40219 |
Please comment or provide details below to improve the information on LANDMARK RECOVERY OUTPATIENT SERVICES LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.