NPIMap

Organization Active NPI

Lifeline Recovery Center, Inc.

  • Substance Abuse Rehabilitation Facility
  • Kevil, KY
National Provider Identifier
1912586389
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
701 Upshaw Lane
Kevil, KY 42053
Phone
(270) 443-4743
Fax
(270) 477-0038
NPI assigned
Apr 5, 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

701 Upshaw Lane
Kevil, KY 42053

Mailing address

PO Box 7652
Paducah, KY 42002-7652

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
18D2220453Lifeline Recovery Center701 Upshaw Lane, Kevil, KY 42053Certificate of waiverApr 12, 2027

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1912586389",
    "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": "701 UPSHAW LANE",
            "city": "KEVIL",
            "state": "KY",
            "postal_code": "42053",
            "telephone_number": "270-443-4743",
            "fax_number": "270-477-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE RECOVERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-05",
        "last_updated": "2024-02-13",
        "certification_date": "2021-04-16",
        "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": []
}

Other providers in Kevil, 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.