in Ft Campbell - Addiction (substance Use Disorder)

- NPI 1083764914

is a Addiction (substance Use Disorder) in Ft Campbell, Kentucky. practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for is 1083764914. The last update date is .

's current location address is 650 Joel Drive, Ft Campbell, Kentucky. You can contact this provider via phone number 2707988727 and fax number 2707988224. The mailing address for is 650 Joel Drive, Ft Campbell, Kentucky. To know further, please read the information below!

Provider Profile Detail

Provider Name
Address 650 Joel Drive, Ft Campbell, Kentucky
Phone Number 2707988727
Fax Number 2707988224
Sole Proprietor --
Credentials --

NPI Number Detail

NPI Number 1083764914
Provider Enumeration Date
Last Updated Date

Provider Mailing Address Detail

Address 650 Joel Drive
City Ft Campbell
State Kentucky (KY)
Post Code 42223
Phone Number 2707988727
Fax Number 2707988224

Provider's Primary Taxonomy Detail

Speciality Addiction (substance Use Disorder)
Taxonomy 101Ya0400X
Licence No 1112
Definition:
A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions.

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
7100364240 KY --

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