Organization
CENTRAL KENTUCKY RECOVERY MANAGEMENT
Active
Other names
New Life Recovery
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY S FRYMAN (OWNER)
(859) 569-3145
Entity
Organization
Contact information
Practice address
1094 US HIGHWAY 27 S STE A, CYNTHIANA, KY 41031-7078
(859) 569-3145
(859) 569-3176
Mailing address
1094 US HIGHWAY 27 S STE A, CYNTHIANA, KY 41031-7078
(859) 569-3145
(859) 569-3176
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100435380
—
KY
01
—
810849
AODE LICENSE
KY
Enumeration date
03/28/2016
Last updated
06/02/2021
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