KENTUCKY PHOENIX PROJECT LLC NPI 1639956527

NPI Information

  • NPI: 1639956527
  • Provider Name: KENTUCKY PHOENIX PROJECT LLC
  • Classification: Clinic/Center - 261QR0405X
  • Specialization: Rehabilitation, Substance Use Disorder
  • Entity Type: Organization
  • CLIA Number: 18D2300714
  • Address: 5230 KY ROUTE 321 STE 6
    PRESTONSBURG, KY
    ZIP 41653
  • Phone: (606) 459-5001

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NPI Details

KENTUCKY PHOENIX PROJECT LLC is a rehabilitation and substance use disorder clinic center in Prestonsburg, KY. KENTUCKY PHOENIX PROJECT LLC NPI is 1639956527. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5230 KY ROUTE 321 STE 6
PRESTONSBURG, KY
ZIP 41653-169
Phone: (606) 459-5001
Fax: (606) 548-5477

The provider's authorized official is Casey Collier .
The authorized official title is Coo and has the following contact phone number (606) 471-4546.

The CLIA number assigned to this NPI record is 18D2300714 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/13/2023 and was last updated on 11/28/2023.

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
1101YA0400XCounselorAddiction (Substance Use Disorder)No
2261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes

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: 11/21/2025

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