Organization
A POINT OF CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENJAMIN D FERGUSON BS, CPCT, CADC (PROGRAM ADMINSTRATOR)
(606) 789-4779
Entity
Organization
Contact information
Practice address
1005 BROADWAY ST, PAINTSVILLE, KY 41240-1408
(606) 789-4779
(606) 789-0381
Mailing address
1005 BROADWAY ST, PAINTSVILLE, KY 41240-1408
(606) 789-4779
(606) 789-0381
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
810272
KY
Other
Enumeration date
10/19/2010
Last updated
10/19/2010
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