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EASTERN AVENUE SOBER LIVING INC NPI 1265020523


NPI Information

NPI: 1265020523
Provider Name: EASTERN AVENUE SOBER LIVING INC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
208 EASTERN AVE
LEXINGTON, KY
ZIP 40508
Phone: (754) 226-5343
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EASTERN AVENUE SOBER LIVING INC is a substance abuse rehabilitation facility in Lexington, KY. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. EASTERN AVENUE SOBER LIVING INC NPI is 1265020523. The provider is registered as an organization entity type.

The provider's business location address is:

208 EASTERN AVE
LEXINGTON, KY
ZIP 40508-918
Phone: (754) 226-5343

The provider's authorized official is Vernon Pressley .
The authorized official title is Board President and has the following contact phone number (185) 953-9410.

The enumeration date for this NPI number is 1/4/2021 and was last updated on 12/10/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1324500000XSubstance Abuse Rehabilitation FacilityYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17100698150MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.