NPIMap

Organization Active NPI

Lifeline Recovery Center, Inc.

  • Substance Abuse Rehabilitation Facility
  • Paducah, KY
National Provider Identifier
1013598317
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
LIFELINE RECOVERY CENTER, INC.
Practice address
2806 Morgan Lane
Paducah, KY 42001
Phone
(270) 448-0961
Fax
(270) 448-1039
NPI assigned
Apr 19, 2021
Last updated
Feb 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ashley Rubeene Miller
Title
Executive Director
Phone
(270) 227-1745

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

2806 Morgan Lane
Paducah, KY 42001

Mailing address

PO Box 7652
Paducah, KY 42002-7652

Other names 1

  • Lifeline Recovery Center, Inc. Women's Campus Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2227586Lifeline Recovery Center2806 Morgan Lane, Paducah, KY 42001Certificate of waiverJun 14, 2027

National Provider Directory

National Provider Directory

Locations

2806 Morgan Ln
Paducah, KY 42001
Phone (270) 448-0961

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1013598317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7652",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420027652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2806 MORGAN LANE",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "42001",
            "telephone_number": "270-448-0961",
            "fax_number": "270-448-1039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE RECOVERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-19",
        "last_updated": "2024-02-13",
        "certification_date": "2021-04-19",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "RUBEENE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "270-227-1745"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifeline Recovery Center, Inc. Women's Campus",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Lifeline Recovery Center, Inc. Women's Campus",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.