Healthcare Provider Details

I. General information

NPI: 1134086820
Provider Name (Legal Business Name): SMITH'S SOBER LIVING HOUSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1462 W LEXINGTON AVE
WINCHESTER KY
40391-1294
US

IV. Provider business mailing address

1462 W LEXINGTON AVE
WINCHESTER KY
40391-1294
US

V. Phone/Fax

Practice location:
  • Phone: 859-355-5233
  • Fax:
Mailing address:
  • Phone: 859-355-5233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALLISON SCROGGINS
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 859-447-6934