Organization Name: | PINNACLE TREATMENT CENTERS KY-I, LLC |
NPI Number: | 1114389822 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SCOTT COHEN (VP FINANCE) |
Mailing Address: | 100 E Broadway # 105-107 Mayfield |
State: | KY US |
Postal Code: | 420662329 |
Phone Number: | 2706238500 |
Fax Number: | |
NPI Enumeration Date: | 03/22/2016 |
NPI Last Update Date: | 03/22/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0405X |
License Number: | 810375 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
Taxonomy Definition: |