| Your Long Run LLC | |
|
2742 Fletcher St Salem VA 24153-2124 | |
| (540) 525-8113 | |
| Not Available |
| Full Name | Your Long Run LLC |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2742 Fletcher St, Salem, Virginia |
| Authorized Official Name and Position | Kathy K Bush (PRESIDENT/PROVIDER) |
| Authorized Official Contact | 5405258113 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Long Run LLC 2742 Fletcher St Salem VA 24153-2124 Ph: (540) 525-8113 | Your Long Run LLC 2742 Fletcher St Salem VA 24153-2124 Ph: (540) 525-8113 |
| NPI Number | 1255851283 |
|---|---|
| Provider Enumeration Date | 06/21/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255851283 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (NU) | Primary |
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