Healthcare Provider Details

I. General information

NPI: 1720353501
Provider Name (Legal Business Name): ABS LINCS KY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2012
Last Update Date: 06/16/2020
Certification Date: 06/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 WALTON WAY
HOPKINSVILLE KY
42240
US

IV. Provider business mailing address

270 WALTON WAY
HOPKINSVILLE KY
42240
US

V. Phone/Fax

Practice location:
  • Phone: 270-886-1919
  • Fax: 270-886-1335
Mailing address:
  • Phone: 270-886-1919
  • Fax: 270-886-1335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVE FILTON
Title or Position: CFO/SVP
Credential:
Phone: 610-768-3300