Healthcare Provider Details

I. General information

NPI: 1093255440
Provider Name (Legal Business Name): EMBRACE HOPE RECOVERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2017
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E JOHN ROWAN BLVD STE 107
BARDSTOWN KY
40004-2060
US

IV. Provider business mailing address

1000 E JOHN ROWAN BLVD STE 107
BARDSTOWN KY
40004-2060
US

V. Phone/Fax

Practice location:
  • Phone: 502-331-6002
  • Fax: 502-331-6122
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CINDY BALLARD
Title or Position: MEMBER
Credential: LCADC
Phone: 502-510-9777