| Tuesday Reign Organization | |
|
5000 N Dixie Hwy Elizabethtown KY 42701-8603 | |
| (972) 774-8460 | |
| Not Available |
| Full Name | Tuesday Reign Organization |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5000 N Dixie Hwy, Elizabethtown, Kentucky |
| Authorized Official Name and Position | Ezell Dante Banks (OWNER/PRESIDENT) |
| Authorized Official Contact | 9727748460 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tuesday Reign Organization 109 Brookefield Ave Apt 1b Elizabethtown KY 42701-4933 Ph: (972) 774-8460 | Tuesday Reign Organization 5000 N Dixie Hwy Elizabethtown KY 42701-8603 Ph: (972) 774-8460 |
| NPI Number | 1962397109 |
|---|---|
| Provider Enumeration Date | 06/10/2025 |
| Last Update Date | 06/10/2025 |
| Certification Date | 06/09/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962397109 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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