| Roots Lifestyle Management Llc | |
|
1795 Alysheba Way Ste 1001a Lexington KY 40509-2282 | |
| (859) 229-3329 | |
| (855) 921-1840 |
| Full Name | Roots Lifestyle Management Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1795 Alysheba Way Ste 1001a, Lexington, Kentucky |
| Authorized Official Name and Position | Stevi Mcdonald (ADMINISTRATOR) |
| Authorized Official Contact | 8594928509 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roots Lifestyle Management Llc 1795 Alysheba Way Ste 1001a Lexington KY 40509-2282 Ph: (859) 229-3329 | Roots Lifestyle Management Llc 1795 Alysheba Way Ste 1001a Lexington KY 40509-2282 Ph: (859) 229-3329 |
| NPI Number | 1780375675 |
|---|---|
| Provider Enumeration Date | 05/19/2023 |
| Last Update Date | 05/19/2023 |
| Certification Date | 05/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780375675 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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