MEDICARE: STABLE MEADOWS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1386086700
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STABLE MEADOWS LLC

Provider Business Mailing Address
First Line	:	2590 JACKS CREEK PIKE
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40515-9514
Country	:	US
Telephone Number	:	859-948-8644
Fax Number	:

Provider Business Practice Location Address
First Line	:	2220 EXECUTIVE DR STE 103
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40505-4871
Country	:	US
Telephone Number	:	859-948-8644
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	DR. ANGELA SPIERS
Credential	:	LPCC
Telephone Number	:	859-948-8644

Provider Enumeration Date	:	07/26/2013
Last Update Date	:	09/08/2014

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Directions to “STABLE MEADOWS LLC ” Practice Location

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