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General NPI Number Information
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NPI Number | 1205664539
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Entity Type | Organization
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Legal Business Name | KEEP HOPE ALIVE
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Dates
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Enumeration Date | 07/26/2024
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 2421 PRESCOTT LN
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City | LEXINGTON
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State | KY
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Zip | 40511-2272
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Country | US
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Telephone | 859-476-6355
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Fax |
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Provider Business Mailing Address
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Address Line | 515 BRECKENRIDGE ST
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City | LEXINGTON
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State | KY
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Zip | 40508-1632
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING AGENT
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Name | JACQUELINE SANDERS
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Credential |
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Telephone | 502-365-3394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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