Organization
NORTHERN KENTUCKY BEHAVIORAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM E ROURKE LCSW (SENIOR VICE PRESIDENT CORPORATE DEV)
(972) 467-4461
Entity
Organization
Contact information
Practice address
2335 STERLINGTON RD, LEXINGTON, KY 40517-3937
(859) 721-1425
Mailing address
PO BOX 4394, BRICK, NJ 08723-0016
(737) 471-1800
(732) 747-1818
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
283Q00000X
Psychiatric Hospital
—
—
Other
Enumeration date
05/23/2022
Last updated
09/08/2023
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