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Organization
DR. WILLIAM H. FULLER MEMORIAL SUBSTANCE ABUSE TREATMENT CENTER
Active
Organization
DR. WILLIAM H. FULLER MEMORIAL SUBSTANCE ABUSE TREATMENT CENTER
Active
Parent organization
WESTERN KY REGIONAL MHMR BOARD INC
Other names
Four Rivers Behavioral Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESTERN KY REGIONAL MHMR BOARD INC
Authorized official
MR. TERRY HUDSPETH MSSW (PRESIDENT/CEO)
(270) 441-2171
Entity
Organization
Contact information
Practice address
1525 CUBA RD, MAYFIELD, KY 42066-6809
(270) 247-2588
(270) 247-0142
Mailing address
1525 CUBA RD, MAYFIELD, KY 42066-6809
(270) 247-0142
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
810023
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
27001015
—
KY
Enumeration date
11/07/2016
Last updated
04/06/2023
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