Healthcare Provider Details

I. General information

NPI: 1720997497
Provider Name (Legal Business Name): TAKE YOUR SEAT BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 NELSON DR
DWALE KY
41621-9024
US

IV. Provider business mailing address

PO BOX 64
DWALE KY
41621-0064
US

V. Phone/Fax

Practice location:
  • Phone: 270-401-7279
  • Fax:
Mailing address:
  • Phone: 270-401-7279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KATARINA VICTORIA GUZMAN
Title or Position: CHIEF OPERATIONS OFFICER
Credential: APSS, CSA
Phone: 270-401-7279