Healthcare Provider Details

I. General information

NPI: 1548645575
Provider Name (Legal Business Name): THE NILE MINISTRIES INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2015
Last Update Date: 07/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4185 LEXINGTON RD
VERSAILLES KY
40383-1736
US

IV. Provider business mailing address

4185 LEXINGTON RD
VERSAILLES KY
40383-1736
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 TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number800191
License Number StateKY

VIII. Authorized Official

Name: CHARLENE F. WILLIAMS
Title or Position: ORGANIZATION DIRECTOR
Credential:
Phone: 859-873-9277