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General NPI Number Information
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NPI Number | 1386086700
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Entity Type | Organization
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Legal Business Name | STABLE MEADOWS LLC
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Dates
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Enumeration Date | 07/26/2013
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Last Update Date | 09/08/2014
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Provider Practice Location Address
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Address Line | 2220 EXECUTIVE DR STE 103
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City | LEXINGTON
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State | KY
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Zip | 40505-4871
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Country | US
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Telephone | 859-948-8644
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Fax |
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Provider Business Mailing Address
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Address Line | 2590 JACKS CREEK PIKE
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City | LEXINGTON
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State | KY
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Zip | 40515-9514
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Country | US
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Telephone | 859-948-8644
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. ANGELA SPIERS
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Credential | LPCC
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Telephone | 859-948-8644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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