Organization
4TH DIMENSION TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LEANN WITT LPCA (CEO)
(606) 273-2134
Entity
Organization
Contact information
Practice address
152 HIGHWAY 990, COALGOOD, KY 40818-5001
(606) 273-2134
Mailing address
152 HIGHWAY 990, COALGOOD, KY 40818-5001
(606) 273-2134
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
800453
—
KY
Enumeration date
06/24/2024
Last updated
06/24/2024
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