| Trio Community | |
|
12706 Crestmoor Cir Prospect KY 40059-9181 | |
| (270) 993-4388 | |
| Not Available |
| Full Name | Trio Community |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 12706 Crestmoor Cir, Prospect, Kentucky |
| Authorized Official Name and Position | Drew Haynes (OWNER) |
| Authorized Official Contact | 2709934388 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Trio Community 12706 Crestmoor Cir Prospect KY 40059-9181 Ph: (270) 993-4388 | Trio Community 12706 Crestmoor Cir Prospect KY 40059-9181 Ph: (270) 993-4388 |
| NPI Number | 1750594420 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750594420 | NPI | - | NPPES |
| 17000654 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Kentucky) | Primary |
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