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General NPI Number Information
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NPI Number | 1316486954
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Entity Type | Organization
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Legal Business Name | RECOVERY CHESTNUT, LLC
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Dates
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Enumeration Date | 02/15/2017
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Last Update Date | 02/15/2017
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Provider Practice Location Address
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Address Line | 1020 W MARKET ST
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City | LOUISVILLE
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State | KY
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Zip | 40202-2630
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Country | US
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Telephone | 502-565-1204
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 W MARKET ST
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City | LOUISVILLE
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State | KY
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Zip | 40202-2630
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Country | US
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Telephone | 502-565-1204
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Fax |
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Authorized Official
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Title or Position | CONSULTANT
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Name | NATASHA SIGMON
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Credential |
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Telephone | 859-608-8656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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