Healthcare Provider Details

I. General information

NPI: 1861321184
Provider Name (Legal Business Name): KENTUCKY RECOVERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1119 BROOKHAVEN RD
FRANKLIN KY
42134-2747
US

IV. Provider business mailing address

1600 WESTGATE CIR STE 255
BRENTWOOD TN
37027-8553
US

V. Phone/Fax

Practice location:
  • Phone: 629-999-1116
  • Fax:
Mailing address:
  • Phone: 629-999-1116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: JIM HYDE
Title or Position: CFO
Credential:
Phone: 629-999-1116