Organization
LUNAR PHASE RESTORATIVE HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WESLEY SAGE BELKNAP-GREENE LCSW (MEMBER)
(859) 200-9858
Entity
Organization
Contact information
Practice address
216 W MAIN ST STE A, RICHMOND, KY 40475-1444
(859) 544-2047
Mailing address
216 W MAIN ST STE A, RICHMOND, KY 40475-1444
(859) 544-2047
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
12/05/2021
Last updated
04/10/2022
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