# YOUR LONG RUN LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255851283
- **Authorized official:** KATHY K BUSH LPC (PRESIDENT/PROVIDER)
- **Authorized official phone:** (540) 525-8113

## Contact information

- **Practice address:** 2742 FLETCHER ST, SALEM, VA 24153-2124
- **Practice address phone:** (540) 525-8113
- **Mailing address:** 2742 FLETCHER ST, SALEM, VA 24153-2124
- **Mailing address phone:** (540) 525-8113

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |

## Other

- **Enumeration date:** 06/21/2017
- **Last updated:** 07/21/2022