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Organization
LAKE CUMBERLAND VETERANS DIRECTED SERVICES
Active
Organization
LAKE CUMBERLAND VETERANS DIRECTED SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRYL MCGAHA (EXECUTIVE DIRECTOR)
(270) 866-4200
Entity
Organization
Contact information
Practice address
2384 LAKEWAY DR, RUSSELL SPRINGS, KY 42642-4509
(270) 866-4200
Mailing address
PO BOX 1570, RUSSELL SPRINGS, KY 42642-1570
(270) 866-4200
Taxonomy
Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
Primary
—
—
Other
Enumeration date
02/22/2018
Last updated
02/22/2018
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