Organization
TRENDING UPWARDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBORAH NOBLE (CO-OWNER)
(606) 272-1874
Entity
Organization
Contact information
Practice address
1754 HIGHWAY 15 N, JACKSON, KY 41339
(606) 272-1874
(606) 824-5126
Mailing address
1754 HIGHWAY 15 N, JACKSON, KY 41339-9405
(606) 272-1874
(606) 824-5126
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
05/24/2017
Last updated
07/21/2022
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