Organization
UNBOUND LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CAMERON VANCE (ADMINISTRATOR)
(270) 320-2605
Entity
Organization
Contact information
Practice address
100 PAR LN STE 102, ELIZABETHTOWN, KY 42701-9059
(270) 506-3385
Mailing address
100 PAR LN STE 102, ELIZABETHTOWN, KY 42701-9059
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/22/2022
Last updated
01/10/2023
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