| Cccl | |
|
114 N Vinson Ave Louisa KY 41230-1150 | |
| (606) 638-3322 | |
| Not Available |
| Full Name | Cccl |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 114 N Vinson Ave, Louisa, Kentucky |
| Authorized Official Name and Position | Shelia Kensinger (CEO/COUNSELOR) |
| Authorized Official Contact | 6066383322 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cccl 114 N Vinson Ave Louisa KY 41230-1150 Ph: (606) 638-3322 | Cccl 114 N Vinson Ave Louisa KY 41230-1150 Ph: (606) 638-3322 |
| NPI Number | 1316487200 |
|---|---|
| Provider Enumeration Date | 02/27/2017 |
| Last Update Date | 02/27/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316487200 | NPI | - | NPPES |
| 1911930832 | Other | KY | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 3252 (Kentucky) | Primary |
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