| Masata, Inc. | |
|
549 Middleburg St. Liberty KY 42539 | |
| (606) 787-1950 | |
| (606) 787-0123 |
| Full Name | Masata, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 549 Middleburg St., Liberty, Kentucky |
| Authorized Official Name and Position | C. Nathan Mcanelly (CLINICAL DIRECTOR, THERAPIST) |
| Authorized Official Contact | 6067871950 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Masata, Inc. Po Box 1116 Liberty KY 42539-1116 Ph: (606) 787-1950 | Masata, Inc. 549 Middleburg St. Liberty KY 42539 Ph: (606) 787-1950 |
| NPI Number | 1356677694 |
|---|---|
| Provider Enumeration Date | 10/21/2009 |
| Last Update Date | 10/21/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356677694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 810273 (Kentucky) | Primary |
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