Organization Name: | COMMONWEALTH COUNSELING CENTERS LLC |
NPI Number: | 1700264918 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BENJAMIN DORSEY FERGUSON (CLINICAL DIRECTOR/SUPERVISOR) |
Mailing Address: | 346 S Central Ave Prestonsburg |
State: | KY US |
Postal Code: | 416531955 |
Phone Number: | 6064621006 |
Fax Number: | |
NPI Enumeration Date: | 05/08/2015 |
NPI Last Update Date: | 08/25/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 324500000X |
License Number: | 1361 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KY |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Substance Abuse Rehabilitation Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |