| Ethas | |
|
149 Enterprise Dr Somerset KY 42501-6155 | |
| (606) 679-6995 | |
| (606) 451-9465 |
| Full Name | Ethas |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 149 Enterprise Dr, Somerset, Kentucky |
| Authorized Official Name and Position | Jason Thayer (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6066796995 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ethas 149 Enterprise Dr Somerset KY 42501-6155 Ph: (606) 679-6995 | Ethas 149 Enterprise Dr Somerset KY 42501-6155 Ph: (606) 679-6995 |
| NPI Number | 1023423449 |
|---|---|
| Provider Enumeration Date | 06/24/2014 |
| Last Update Date | 06/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023423449 | NPI | - | NPPES |
| 7100190490 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 7100190490 (Kentucky) | Primary |
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