DAGAMAC ENTERPRISES LLC NPI 1801047808

NPI Information

NPI: 1801047808
Provider Name: DAGAMAC ENTERPRISES LLC

Doing Business As: NEW HORIZONS COUNSELING/BROKEN WINGS PGM

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
441 HOPKINSVILLE ST
GREENVILLE, KY
ZIP 42345
Phone: (270) 338-2280
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DAGAMAC ENTERPRISES LLC is a rehabilitation and substance use disorder clinic center in Greenville, KY. DAGAMAC ENTERPRISES LLC NPI is 1801047808. The provider is registered as an organization entity type.
The provider Is Doing Business As New Horizons Counseling/broken Wings Pgm.

The provider's business location address is:

441 HOPKINSVILLE ST
GREENVILLE, KY
ZIP 42345-101
Phone: (270) 338-2280
Fax: (270) 338-0795

The provider's authorized official is Darryl Wade Mcintosh .
The authorized official title is Counselor/therapist and has the following contact phone number (270) 338-2280.

The enumeration date for this NPI number is 10/8/2008 and was last updated on 10/8/2008.

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	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	KY-0191	KENTUCKY	Yes

What is NPI?

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

NPI Synchronization or Removal

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