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General NPI Number Information
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NPI Number | 1982545976
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Entity Type | Organization
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Legal Business Name | ROOTS SUPPORT SERVICES
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Dates
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Enumeration Date | 04/03/2026
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Last Update Date | 04/03/2026
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Provider Practice Location Address
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Address Line | 31 STONECROP LN
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City | BROWNSVILLE
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State | KY
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Zip | 42210-9550
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Country | US
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Telephone | 270-779-3447
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Fax |
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Provider Business Mailing Address
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Address Line | 437 WITT RD
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City | BOWLING GREEN
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State | KY
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Zip | 42101-9636
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Country | US
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Telephone | 270-779-3447
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ABBY LACEFIELD
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Credential |
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Telephone | 270-779-3447
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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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