Organization
LAKE CUMBERLAND RECOVERY, INC
Active
Parent organization
LAKE CUMBERLAND RECOVERY, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKE CUMBERLAND RECOVERY, INC
Authorized official
MIKKLE HAMPTON (CEO)
(606) 341-1160
Entity
Organization
Contact information
Practice address
801 S CENTRAL AVE, CAMPBELLSVILLE, KY 42718-1107
(606) 341-1160
(606) 485-4128
Mailing address
PO BOX 305, BURNSIDE, KY 42519-0305
(606) 341-1160
(606) 485-4218
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
07/26/2022
Last updated
07/26/2022
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