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MAHOGHANY TREE ROOTED RESOURCES
NPI 1508645201
Clinic/Center - Multi-Specialty in Louisville, KY

Active since September 22, 2023
4059 LA SALLE AVE, LOUISVILLE, KY 40215(502) 579-0170 Get Directions Write a Review

NPPES record last updated: September 22, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mahoghany Tree Rooted Resources NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAHOGHANY TREE ROOTED RESOURCES (NPI 1508645201) is a healthcare organization registered as a multi-specialty in Louisville, Kentucky and active in the NPI registry since September 2023. The organization lists Nasira Mah-jabeen, Credentialing Agent, as its authorized official.

NPPES Registry Identity

NPI1508645201
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameMAHOGHANY TREE ROOTED RESOURCES
Location Address4059 LA SALLE AVELouisville, KY 40215-1321
Mailing Address642 Cecil AveLouisville, KY 40211-3162
Phone(502) 579-0170
Organization SubpartNo
Authorized OfficialNasira Mah-jabeenCredentialing Agent · (502) 579-0170
Enumeration DateSeptember 22, 2023
NPPES CertifiedSeptember 22, 2023
✔ NPI 1508645201 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
4059 LA SALLE AVE, Louisville, KY 40215
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mahoghany Tree Rooted Resources's NPI number?

The NPI number for Mahoghany Tree Rooted Resources is 1508645201. It was assigned to this organization in the NPPES registry on September 22, 2023.

Where is Mahoghany Tree Rooted Resources located?

Mahoghany Tree Rooted Resources is located at 4059 La Salle Ave, Louisville, KY 40215. The listed phone number is (502) 579-0170.

What is Mahoghany Tree Rooted Resources's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

When was this NPI record last updated?

The NPPES record for Mahoghany Tree Rooted Resources was last updated on September 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.