| Lifetree Marriage And Family Therapy Llc | |
|
121 Wannamaker Blvd Richmond KY 40475-8037 | |
| (859) 559-8002 | |
| Not Available |
| Full Name | Lifetree Marriage And Family Therapy Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 121 Wannamaker Blvd, Richmond, Kentucky |
| Authorized Official Name and Position | Ray Colon Coates (OWNER) |
| Authorized Official Contact | 8595598002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifetree Marriage And Family Therapy Llc 121 Wannamaker Blvd Richmond KY 40475-8037 Ph: (859) 559-8002 | Lifetree Marriage And Family Therapy Llc 121 Wannamaker Blvd Richmond KY 40475-8037 Ph: (859) 559-8002 |
| NPI Number | 1366259855 |
|---|---|
| Provider Enumeration Date | 12/17/2024 |
| Last Update Date | 12/30/2024 |
| Certification Date | 12/30/2024 |
| Medicare PECOS PAC ID | 5092244012 |
|---|---|
| Medicare Enrollment ID | O20250121001694 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366259855 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Ray C Coates |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1346748035 PECOS PAC ID: 6901259134 Enrollment ID: I20240124002136 |
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