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General NPI Number Information
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NPI Number | 1053692012
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Entity Type | Organization
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Legal Business Name | AWARENESS AND DISCOVERY GROUP LLC
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Dates
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Enumeration Date | 09/06/2011
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Last Update Date | 09/24/2015
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Provider Practice Location Address
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Address Line | 2 DORTHA AVE
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City | FLORENCE
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State | KY
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Zip | 41042-2014
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Country | US
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Telephone | 859-525-1487
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Fax | 859-525-7811
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Provider Business Mailing Address
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Address Line | 2 DORTHA AVE
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City | FLORENCE
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State | KY
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Zip | 41042-2014
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Country | US
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Telephone | 859-525-1487
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Fax | 859-525-7811
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL SERVICES
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Name | MR. RICK N. HAMM
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Credential | LCSW
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Telephone | 859-525-1487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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