Healthcare Provider Details

I. General information

NPI: 1518422047
Provider Name (Legal Business Name): RAY OF HOPE RECOVERIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2019
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1158 LEXINGTON RD
GEORGETOWN KY
40324-9330
US

IV. Provider business mailing address

237 QUAIL RUN DRIVE
GEORGETOWN KY
40324
US

V. Phone/Fax

Practice location:
  • Phone: 502-863-2277
  • Fax: 502-863-6334
Mailing address:
  • Phone: 859-608-7839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CEDRIC CRAIG
Title or Position: PRESIDENT
Credential: MD
Phone: 859-608-7839