Organization
TIME OUT COMMUNITY COUNSELING AND CORRECTIONAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA SUE FARLEY RN (OFFICE MANAGER/EDUCATOR)
(270) 237-3463
Entity
Organization
Contact information
Practice address
1502 PARK CITY GLASGOW RD, GLASGOW, KY 42141-7209
(270) 678-3138
Mailing address
102 W PUBLIC SQ, SCOTTSVILLE, KY 42164-1175
(270) 237-3463
(270) 237-3464
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0531
KY
163W00000X
Registered Nurse
1107277
KY
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
1107277
KY
163WC0400X
Case Management Registered Nurse
1107277
KY
163WC1600X
Continuing Education/Staff Development Registered Nurse
1107277
KY
251S00000X
Community/Behavioral Health Agency
810288
KY
Other
Enumeration date
09/14/2010
Last updated
09/23/2010
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