Lake Cumberland Recovery, Inc
Organization Active NPI Substance Use Disorder Rehabilitation Clinic/Center · Campbellsville, KY
NPI 1043946783 · NPPES record last updated Jul 26, 2022
Key facts
- NPI
- 1043946783
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
- Legal business name
- LAKE CUMBERLAND RECOVERY, INC
- Practice address
- 801 S Central Ave
Campbellsville, KY 42718-1107 - Phone
- (606) 341-1160
- Fax
- (606) 485-4128
- NPI assigned
- Jul 26, 2022
- Organization subpart
- Yes
- Parent organization (as reported)
- LAKE CUMBERLAND RECOVERY, INC
Authorized official
- Name
- Mikkle Hampton
- Title
- Ceo
- Phone
- (606) 341-1160
Corporate family (same tax ID) 5
National Provider Directory
- Tax ID family
- Lake Cumberland Recovery Inc
- Part of
- Lake Cumberland Recovery Inc
Locations
801 S Central Ave
Campbellsville, KY 42718
Phone (606) 341-1160
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | Yes |
Addresses
Primary practice location
801 S Central Ave
Campbellsville, KY 42718-1107
Mailing address
PO Box 305
Burnside, KY 42519-0305
Phone (606) 341-1160
Other providers in Campbellsville, KY
- Lake Cumberland District Health Dept
- Lake Cumberland District Health Dept
- Lake Cumberland District Health Dept
- Lake Cumberland District Health Dept
- Lake Cumberland District Health Dept
- Brittanie Landis
- Latashia Lane
- Megan Yvette Lane
- Cambria Laramore
- Sigrid Lawhorn
All providers in Campbellsville, KY · Substance Use Disorder Rehabilitation Clinic/Center in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.