EAST KENTUCKY REHABILITATION CENTER NPI 1790114015

NPI Information

NPI: 1790114015
Provider Name: EAST KENTUCKY REHABILITATION CENTER
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 18D2068832

Address:
290 E COURT ST
PRESTONSBURG, KY
ZIP 41653
Phone: (606) 263-4714
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EAST KENTUCKY REHABILITATION CENTER is a rehabilitation and substance use disorder clinic center in Prestonsburg, KY. EAST KENTUCKY REHABILITATION CENTER NPI is 1790114015. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

290 E COURT ST
PRESTONSBURG, KY
ZIP 41653-932
Phone: (606) 263-4714

The provider's authorized official is David Gearheart .
The authorized official title is President/ceo and has the following contact phone number (606) 263-4714.

The CLIA number assigned to this NPI record is 18D2068832 - mobile lab with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/6/2013 and was last updated on 2/19/2016.

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	101Y00000X	Counselor				No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	1061	KENTUCKY	No
3	101YP2500X	Counselor	Professional	1360	KENTUCKY	No
4	324500000X	Substance Abuse Rehabilitation Facility		810498	KENTUCKY	No
5	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	1061	KENTUCKY	Yes

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: 11/14/2023

NPI Synchronization or Removal

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