Organization
FOOTHILLS ACADEMY, INC.
Active
Other names
Otter Creek, Community Based Interventions
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA ANN SIMMONS LPCC, LCADC (DIRECTOR)
(606) 343-0216
Entity
Organization
Contact information
Practice address
80 ROLLING HILLS BLVD, MONTICELLO, KY 42633-9005
(606) 343-0216
(606) 343-0224
Mailing address
80 ROLLING HILLS BLVD, MONTICELLO, KY 42633-9005
(606) 343-0216
(606) 343-0224
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
500595
KY
3245S0500X
Children's Substance Abuse Rehabilitation Facility
500595
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100317630
—
KY
Enumeration date
02/28/2012
Last updated
05/14/2021
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