Living Waters of Ky, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

LIVING WATERS OF KY, INC

Practice address

920 S Main St
Nicholasville, KY 40356-2152

Phone

(859) 305-6673

Fax

(859) 305-6674

NPI assigned

Jul 24, 2019

Last updated

Jul 24, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Johnny Templin

Title

Ceo/President

Phone

(859) 270-6919

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563926400000",
    "number": "1205489622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 S MAIN ST",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403562152",
            "telephone_number": "859-305-6673",
            "fax_number": "859-305-6674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 S MAIN ST",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403562152",
            "telephone_number": "859-305-6673",
            "fax_number": "859-305-6674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WATERS OF KY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-07-24",
        "status": "A",
        "authorized_official_last_name": "TEMPLIN",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "859-270-6919"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AODE",
            "identifier": "810689",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BHSO",
            "identifier": "800328",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Nicholasville, KY
• Providers in Nicholasville, KY by specialty
• Community/Behavioral Health Agency in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.