OrganizationActive
Allegiance to Self
NPI 1679389332 · Substance Abuse Rehabilitation Facility · Louisville, KY
Provider details
- NPI number
- 1679389332
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Antwone Shaw, Ceo(502) 322-2065
Specialties & taxonomies
Residential Treatment Facilities
- Mental Health Counselor101YM0800X
Behavioral Health & Social Service Providers
- Case Management Agency251B00000X
Agencies
Practice location
3711 W Broadway
Louisville, KY 40211-2847
Phone: (502) 322-2065
Approximate (ZIP-level) locationGet directions
Mailing address
9508 Yellow Pine Ct
Louisville, KY 40229-1642
Registry dates
- Enumerated
- 2024-12-09
- Last updated
- 2024-12-10
- Certified
- 2024-12-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.