| Adanta Group Epsdt | |
|
130 Southern School Rd Somerset KY 42501-3223 | |
| (606) 679-4782 | |
| (606) 678-5296 |
| Full Name | Adanta Group Epsdt |
|---|---|
| Speciality | Clinic/center - Rehabilitation |
| Location | 130 Southern School Rd, Somerset, Kentucky |
| Authorized Official Name and Position | Jack Lewis (HR DIRECTOR) |
| Authorized Official Contact | 6066794782 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Adanta Group Epsdt 130 Southern School Rd Somerset KY 42501-3223 Ph: (606) 679-4782 | Adanta Group Epsdt 130 Southern School Rd Somerset KY 42501-3223 Ph: (606) 679-4782 |
| NPI Number | 1639206493 |
|---|---|
| Provider Enumeration Date | 02/28/2007 |
| Last Update Date | 12/26/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639206493 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QR0400X | Clinic/center - Rehabilitation | (* (Not Available)) | Primary |
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