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Organization

KENTUCKY ADDICTION CENTERS WINCHESTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TROUPER KRUEGER (CSO-HHR)
(979) 324-5456
Entity
Organization

Contact information

Practice address
625 TECH DR STE B, WINCHESTER, KY 40391-9662
(979) 324-5456
Mailing address
625 TECH DR STE B, WINCHESTER, KY 40391-9662
(979) 324-5456

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
207Q00000X
Family Medicine Physician
Primary
207QA0401X
Addiction Medicine (Family Medicine) Physician
363LF0000X
Family Nurse Practitioner

Other

Enumeration date
03/25/2021
Last updated
03/25/2021
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