Healthcare Provider Details

I. General information

NPI: 1184037798
Provider Name (Legal Business Name): THE NILE MINISTRIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2014
Last Update Date: 07/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4185 LEXINGTON ROAD
VERSAILLES KY
40383
US

IV. Provider business mailing address

4185 LEXINGTON ROAD
VERSAILLES KY
40383
US

V. Phone/Fax

Practice location:
  • Phone: 859-873-9277
  • Fax: 859-873-9280
Mailing address:
  • Phone: 859-873-9277
  • Fax: 859-873-9280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number810386
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number800191
License Number StateKY

VIII. Authorized Official

Name: MRS. CHARLENE WILLIAMS
Title or Position: OWNER
Credential:
Phone: 859-312-5626