RENEW ADDICTION TREATMENT CENTER NPI 1063810091

NPI Information

NPI: 1063810091
Provider Name: RENEW ADDICTION TREATMENT CENTER

Doing Business As: BEHAVIORAL HEALTH PROFESSIONALS

Classification: Family Medicine - 207QA0401X
Entity Type: Organization

Specialization: Addiction Medicine

Address:
400 VENTERS LN STE 100
PIKEVILLE, KY
ZIP 41501
Phone: (606) 653-1505
Get Directions

RENEW ADDICTION TREATMENT CENTER is an addiction medicine family medicine in Pikeville, KY. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. RENEW ADDICTION TREATMENT CENTER NPI is 1063810091. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Behavioral Health Professionals.

The provider's business location address is:

400 VENTERS LN STE 100
PIKEVILLE, KY
ZIP 41501-016
Phone: (606) 653-1505

The provider's authorized official is Amber Sisco .
The authorized official title is Managing Member and has the following contact phone number (606) 653-1505.

The enumeration date for this NPI number is 12/8/2014 and was last updated on 9/9/2022.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RA0401X	Internal Medicine	Addiction Medicine	740318	KENTUCKY	No
2	2084A0401X	Psychiatry & Neurology	Addiction Medicine	740318	KENTUCKY	No
3	207QA0401X	Family Medicine	Addiction Medicine	740318	KENTUCKY	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	740318	OTHER	KENTUCKY	STATE FACILITY LICENSE- SPECIAL HEALTH CLINIC

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

NPI Synchronization or Removal

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.

« Previous NPI

Next NPI »