Eastern Avenue Sober Living Inc

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

EASTERN AVENUE SOBER LIVING INC

Practice address

208 Eastern Ave
Lexington, KY 40508-1918

Phone

(754) 226-5343

NPI assigned

Jan 4, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Vernon Pressley, ADMINISTRATOR

Title

Board President

Phone

(185) 953-9410

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Eastern Avenue Sober Living Inc Doing business as

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639094400000",
    "number": "1265020523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 MASTERSON STATION DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405118736",
            "telephone_number": "859-539-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 EASTERN AVE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405081918",
            "telephone_number": "754-226-5343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN AVENUE SOBER LIVING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A",
        "authorized_official_last_name": "PRESSLEY",
        "authorized_official_first_name": "VERNON",
        "authorized_official_title_or_position": "BOARD PRESIDENT",
        "authorized_official_telephone_number": "185-953-9410",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100698150",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastern Avenue Sober Living Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaitlyn Marie Eason, DPT
• Lindsey Hines Eason
• Kimberly Denise East, APRN-WHNP-BC
• Nikki Giovanni Easter
• Rachel Easterling
• Eastern Kentucky Treatment Center of Lexington
• Eastern Kentucky University
• Eastern Kentucky University
• Ruth Clark Eastham
• Eastland Chiropractic PSC

• Substance Abuse Rehabilitation Facility in Lexington, KY
• Providers in Lexington, KY by specialty
• Substance Abuse Rehabilitation Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; 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.