| Kentucky Phoenix Project Llc | |
|
5230 Ky Route 321 Ste 6 Prestonsburg KY 41653-9169 | |
| (606) 459-5001 | |
| (606) 548-5477 |
| Full Name | Kentucky Phoenix Project Llc |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 5230 Ky Route 321 Ste 6, Prestonsburg, Kentucky |
| Authorized Official Name and Position | Casey Collier (COO) |
| Authorized Official Contact | 6064714546 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kentucky Phoenix Project Llc Po Box 126 Prestonsburg KY 41653-0126 Ph: (606) 459-5001 | Kentucky Phoenix Project Llc 5230 Ky Route 321 Ste 6 Prestonsburg KY 41653-9169 Ph: (606) 459-5001 |
| NPI Number | 1639956527 |
|---|---|
| Provider Enumeration Date | 09/13/2023 |
| Last Update Date | 11/28/2023 |
| Certification Date | 11/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639956527 | NPI | - | NPPES |
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