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General NPI Number Information
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NPI Number | 1275961849
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Entity Type | Organization
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Legal Business Name | KVC BEHAVIORIAL HEALTHCARE
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Dates
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Enumeration Date | 10/17/2013
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Last Update Date | 10/17/2013
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Provider Practice Location Address
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Address Line | 561 N LAKE DR
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City | PRESTONSBURG
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State | KY
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Zip | 41653-1278
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Country | US
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Telephone | 606-216-4186
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Fax |
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Provider Business Mailing Address
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Address Line | 5836 THORNTON RD
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City | THORNTON
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State | KY
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Zip | 41855-9059
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Country | US
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Telephone | 606-216-4186
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. SONJI NICOLE ADAMS
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Credential | LPCC, CADC
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Telephone | 606-216-4186
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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 | KY
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