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General NPI Number Information
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NPI Number | 1871317180
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Entity Type | Organization
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Legal Business Name | NEULIFE REHABILITATION OF KENTUCKY INC
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 1125 31W BYPASS
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City | BOWLING GREEN
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State | KY
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Zip | 42101
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Country | US
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Telephone | 844-936-5433
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Fax |
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Provider Business Mailing Address
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Address Line | 189 ADAM SHEPHERD PARKWAY, SUITE 17 PMB #280
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City | SHEPHERDSVILLE
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State | KY
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Zip | 40165
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Country | US
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Telephone | 844-936-5433
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. PATRICK GLENN KELLEY
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Credential |
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Telephone | 844-936-5433
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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