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General NPI Number Information
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NPI Number | 1669975165
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Entity Type | Organization
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Legal Business Name | ADDICTION TREATMENT CENTERS LLC
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Dates
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Enumeration Date | 03/12/2018
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Last Update Date | 05/11/2018
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Provider Practice Location Address
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Address Line | 1736 ALEXANDRIA DR STE 225
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City | LEXINGTON
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State | KY
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Zip | 40504-3159
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Country | US
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Telephone | 859-492-0152
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Fax |
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Provider Business Mailing Address
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Address Line | 118 RUCKER AVE
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City | GEORGETOWN
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State | KY
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Zip | 40324-1256
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Country | US
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Telephone | 859-492-0152
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DEDE STRATTON
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Credential | CSW
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Telephone | 859-492-0152
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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 | 800271
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License Number State | KY
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