| Living Free Recovery, Pllc | |
|
400 University Dr Prestonsburg KY 41653-1080 | |
| (606) 886-0224 | |
| (606) 886-9908 |
| Full Name | Living Free Recovery, Pllc |
|---|---|
| Speciality | Family Medicine - Addiction Medicine |
| Location | 400 University Dr, Prestonsburg, Kentucky |
| Authorized Official Name and Position | Mary Fairchild (BILLING MANAGER) |
| Authorized Official Contact | 6068860224 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Free Recovery, Pllc Po Box 1810 Prestonsburg KY 41653-5810 Ph: (606) 886-0224 | Living Free Recovery, Pllc 400 University Dr Prestonsburg KY 41653-1080 Ph: (606) 886-0224 |
| NPI Number | 1255881033 |
|---|---|
| Provider Enumeration Date | 10/05/2016 |
| Last Update Date | 10/05/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255881033 | NPI | - | NPPES |
| 64061328 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 02805 (Kentucky) | Secondary |
| 207QA0401X | Family Medicine - Addiction Medicine | 02805 (Kentucky) | Primary |
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