| Possibility Place Psc | |
|
56 Cambridge Ct Vine Grove KY 40175-5100 | |
| (270) 501-0858 | |
| (270) 828-8051 |
| Full Name | Possibility Place Psc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 56 Cambridge Ct, Vine Grove, Kentucky |
| Authorized Official Name and Position | Michael Trotta (PRESIDENT) |
| Authorized Official Contact | 2705010858 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Possibility Place Psc 56 Cambridge Ct Vine Grove KY 40175-5100 Ph: (270) 501-0858 | Possibility Place Psc 56 Cambridge Ct Vine Grove KY 40175-5100 Ph: (270) 501-0858 |
| NPI Number | 1225334337 |
|---|---|
| Provider Enumeration Date | 02/07/2011 |
| Last Update Date | 02/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225334337 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1095557 (Florida) | Primary |
Shiloh City Of Peace Foundation Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 280 Briggs Ln, Vine Grove, KY 40175 Phone: 270-300-1841 |