Healthcare Provider Details

I. General information

NPI: 1982102109
Provider Name (Legal Business Name): SPERO HEALTH OF KENTUCKY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2018
Last Update Date: 01/22/2021
Certification Date: 01/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 BELINDA BLVD STE 100
DANVILLE KY
40422-3217
US

IV. Provider business mailing address

155 FRANKLIN RD STE 430
BRENTWOOD TN
37027-4646
US

V. Phone/Fax

Practice location:
  • Phone: 866-755-4258
  • Fax:
Mailing address:
  • Phone: 615-265-0371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD DULANY ADAMS
Title or Position: CFO
Credential:
Phone: 615-265-0371