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General NPI Number Information
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NPI Number | 1356997449
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Entity Type | Organization
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Legal Business Name | BEALL RECOVERY CLINICS
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Dates
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Enumeration Date | 08/14/2019
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 1145 W LEXINGTON AVE STE C
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City | WINCHESTER
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State | KY
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Zip | 40391-1290
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Country | US
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Telephone | 859-385-4093
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Fax | 859-355-4058
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Provider Business Mailing Address
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Address Line | 1145 W LEXINGTON AVE STE C
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City | WINCHESTER
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State | KY
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Zip | 40391-1290
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Country | US
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Telephone | 859-385-4093
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Fax | 859-355-4058
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Authorized Official
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Title or Position | OWNER
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Name | TIFFANY OSBORNE
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Credential |
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Telephone | 859-385-4093
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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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 | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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