| Living Waters Of Ky, Inc | |
|
920 S Main St Nicholasville KY 40356-2152 | |
| (859) 305-6673 | |
| (859) 305-6674 |
| Full Name | Living Waters Of Ky, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 920 S Main St, Nicholasville, Kentucky |
| Authorized Official Name and Position | Johnny Templin (CEO/PRESIDENT) |
| Authorized Official Contact | 8592706919 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Waters Of Ky, Inc 920 S Main St Nicholasville KY 40356-2152 Ph: (859) 305-6673 | Living Waters Of Ky, Inc 920 S Main St Nicholasville KY 40356-2152 Ph: (859) 305-6673 |
| NPI Number | 1205489622 |
|---|---|
| Provider Enumeration Date | 07/24/2019 |
| Last Update Date | 07/24/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205489622 | NPI | - | NPPES |
| 800328 | Other | KY | BHSO |
| 810689 | Other | KY | AODE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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