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General NPI Number Information
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NPI Number | 1720952476
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Entity Type | Organization
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Legal Business Name | ADJUVANT BEHAVIORAL HEALTH INC
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Dates
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Enumeration Date | 10/03/2025
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 3499 BLAZER PKWY STE 330
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City | LEXINGTON
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State | KY
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Zip | 40509-2828
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Country | US
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Telephone | 866-912-2746
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Fax | 800-420-2305
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Provider Business Mailing Address
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Address Line | 11754 JOLLYVILLE RD STE 110
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City | AUSTIN
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State | TX
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Zip | 78759-3948
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Country | US
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Telephone | 866-912-2746
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Fax | 800-420-2305
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Authorized Official
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Title or Position | CCO
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Name | JIMMY MYERS
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Credential |
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Telephone | 866-912-2746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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