Healthcare Provider Details

I. General information

NPI: 1447764352
Provider Name (Legal Business Name): A BRIGHTER FUTURE ABI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2017
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 BOSTON RD STE 112
LEXINGTON KY
40514-1564
US

IV. Provider business mailing address

3650 BOSTON RD STE 112
LEXINGTON KY
40514-1564
US

V. Phone/Fax

Practice location:
  • Phone: 502-554-5601
  • Fax: 866-948-1192
Mailing address:
  • Phone: 502-554-5601
  • Fax: 866-948-1192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER LYNN STOVER
Title or Position: EXECUTIVE DIRECTOR
Credential: M.A.
Phone: 502-554-5601