Organization
LIVING WATERS OF KY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNNY TEMPLIN (CEO/PRESIDENT)
(859) 270-6919
Entity
Organization
Contact information
Practice address
920 S MAIN ST, NICHOLASVILLE, KY 40356-2152
(859) 305-6673
(859) 305-6674
Mailing address
920 S MAIN ST, NICHOLASVILLE, KY 40356-2152
(859) 305-6673
(859) 305-6674
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
800328
BHSO
KY
01
—
810689
AODE
KY
Enumeration date
07/24/2019
Last updated
07/24/2019
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