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General NPI Number Information
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NPI Number | 1124394499
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Entity Type | Organization
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Legal Business Name | HOPE IN THE MOUNTAINS
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Dates
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Enumeration Date | 03/30/2012
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Last Update Date | 03/30/2012
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Provider Practice Location Address
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Address Line | 105 TRIMBLE CHAPEL SQ
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City | PRESTONSBURG
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State | KY
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Zip | 41653-8462
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Country | US
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Telephone | 606-874-0240
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Fax | 606-874-8666
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Provider Business Mailing Address
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Address Line | P.O. BOX 730
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City | PAINTSVILLE
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State | KY
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Zip | 41240
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Country | US
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Telephone | 606-874-0240
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Fax | 606-874-8666
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. ROSANNA RENEE MCCOY
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Credential | M.ED., NCC, CADC, RN
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Telephone | 606-874-0240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 810255
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License Number State | KY
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