18D2057373 CLIA NUMBER - BHG XXIV, LLC DBA BHG PAINTSVILLE TREATMENT CENTER

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Laboratory Demographics

CLIA Number: 18D2057373

Facility Name: BHG XXIV, LLC DBA BHG PAINTSVILLE TREATMENT CENTER

Facility Address:
628 JEFFERSON AVENUE
PAINTSVILLE, KY
ZIP 41240
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Facility Phone Number: 606 789-6966

Facility Type: Other - SUBSTANCE ABUSE TREATMENT

Certificate Type: Waiver

NPI Number: 1568808640

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	18D2057373
LAB Type	Other - SUBSTANCE ABUSE TREATMENT
Facility Name	BHG XXIV, LLC DBA BHG PAINTSVILLE TREATMENT CENTER
Street	628 JEFFERSON AVENUE
City	PAINTSVILLE
State	KY
ZIP	41240
Phone	606 789-6966
CertificateType	4
CertificateEffectiveDate	4/15/2023
CertificateExpirationDate	4/14/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024