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NPI Code Detail

MEDICARE: COMMONWEALTH TREATMENT CENTER

MEDICARE: COMMONWEALTH TREATMENT CENTER
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
1324500000XSubstance Abuse Rehabilitation Facility21507KY

General Provider Information

NPI Number : 1467870022
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMONWEALTH TREATMENT CENTER
Provider Business Mailing Address
First Line : 101 MEDICAL HEIGHTS DR STE P
Second Line :
City : FRANKFORT
State : KY
Zip : 40601-4137
Country : US
Telephone Number : 502-235-5308
Fax Number : 502-352-2779
Provider Business Practice Location Address
First Line : 101 MEDICAL HEIGHTS DR STE P
Second Line :
City : FRANKFORT
State : KY
Zip : 40601-4137
Country : US
Telephone Number : 502-235-5308
Fax Number : 502-352-2779
Authorized Official
Title or Position : OFFICE MANAGER
Name : MR. MORGAN ALBERT GONZALEZ
Credential :
Telephone Number : 502-235-5308
Provider Enumeration Date : 04/01/2014
Last Update Date : 04/01/2014

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Directions to “COMMONWEALTH TREATMENT CENTER ” Practice Location

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