Healthcare Provider Details

I. General information

NPI: 1437772738
Provider Name (Legal Business Name): KEY RECOVERY SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2020
Last Update Date: 05/20/2020
Certification Date: 05/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6487 KY HIGHWAY 476
BULAN KY
41722-8717
US

IV. Provider business mailing address

1684 BALLARD RD
LAWRENCEBURG KY
40342-9309
US

V. Phone/Fax

Practice location:
  • Phone: 859-230-2915
  • Fax:
Mailing address:
  • Phone: 859-230-2915
  • Fax: 859-488-7448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TERRY SCOTT
Title or Position: OWNER/MEMBER
Credential:
Phone: 859-230-2915