| Renew Out-patient & Residential Treatment Services Llc | |
|
4963 Us Highway 23 S Suite 121 Ivel KY 41642-9067 | |
| (606) 653-1505 | |
| Not Available |
| Full Name | Renew Out-patient & Residential Treatment Services Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4963 Us Highway 23 S, Ivel, Kentucky |
| Authorized Official Name and Position | Eugene Sisco (MANAGING MEMBER) |
| Authorized Official Contact | 6066531505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew Out-patient & Residential Treatment Services Llc Po Box 678 Betsy Layne KY 41605-0678 Ph: () - | Renew Out-patient & Residential Treatment Services Llc 4963 Us Highway 23 S Suite 121 Ivel KY 41642-9067 Ph: (606) 653-1505 |
| NPI Number | 1740670785 |
|---|---|
| Provider Enumeration Date | 01/29/2015 |
| Last Update Date | 01/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740670785 | NPI | - | NPPES |
| 800139 | Other | KY | BEHAVIORAL HEALTH SERVICES ORGANIZATION |
| 810407 | Other | KY | ALCOHOL AN OTHER DRUG TREATMENT ENTITY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 800139 (Kentucky) | Primary |
Alcohol & Drug Abuse Prevention & Treatment Specialties, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4963 Us Hwy 23 N, Suite 121, Ivel, KY 41642 Phone: 606-653-1505 |