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General NPI Number Information
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NPI Number | 1851097281
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Entity Type | Organization
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Legal Business Name | JOURNEY TO HEALING
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Dates
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Enumeration Date | 02/07/2023
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 153 WEST TOM T HALL BLVD
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City | OLIVE HILL
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State | KY
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Zip | 41164
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Country | US
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Telephone | 606-939-8756
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1107
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City | OLIVE HILL
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State | KY
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Zip | 41164-1107
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Country | US
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Telephone | 606-939-8756
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Fax |
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Authorized Official
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Title or Position | CLINICAL SUPERVISOR
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Name | TONYA M BOND JUDD
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Credential | LPCC
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Telephone | 606-939-8756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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