Renew Addiction Treatment Center

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

740318 Issued in KY

Legal business name

RENEW ADDICTION TREATMENT CENTER

Doing business as

Behavioral Health Professionals
Renew ATC

Practice address

400 Venters LN Ste 100
Pikeville, KY 41501-3016

Phone

(606) 653-1505

NPI assigned

Dec 8, 2014

Organization subpart

Yes

Parent organization

ADAPTAs reported in NPPES

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

Authorized official

Name

Mrs. Amber Sisco

Title

Managing Member

Phone

(606) 653-1505

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 2

• Behavioral Health Professionals Doing business as
• Renew ATC Doing business as

Part of

Alcohol Drug Abuse Prevention Treatment Specialties LLC

Locations

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662681600000",
    "number": "1063810091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1285",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415021285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 VENTERS LN STE 100",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415013016",
            "telephone_number": "606-653-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW ADDICTION TREATMENT CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADAPT",
        "enumeration_date": "2014-12-08",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A",
        "authorized_official_last_name": "SISCO",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "606-653-1505",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "KY",
            "license": "740318",
            "primary": true
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "KY",
            "license": "740318",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "KY",
            "license": "740318",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE FACILITY LICENSE- SPECIAL HEALTH CLINIC",
            "identifier": "740318",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Behavioral Health Professionals",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Renew ATC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patrese Danielle Reed, PHARMD
• Renee E Reeder, OD
• Douglas Mitchell Reeves, MD
• Regina Coleman Compton, O.D., PSC
• Ashley Reinstetle, OD
• Renew Residential Treatment Services (Brookside)
• Katelyn Alexandra Rentel, LPCC
• Respiratory Plus Healthcare Inc
• Betty Sue Reynolds, APRN
• Christopher C. Reynolds, M.D.

• Addiction Medicine (Family Medicine) Physician in Pikeville, KY
• Providers in Pikeville, KY by specialty
• Addiction Medicine (Family Medicine) Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.