Organization
MYSTYK RIVER RETREAT CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARNET ELEANOR WORTHINGTON LMT (MANAGER/CO-OWNER)
(502) 732-9938
Entity
Organization
Contact information
Practice address
1732 KINGSRIDGE RD, CARROLLTON, KY 41008-8655
(502) 732-9938
(502) 732-9938
Mailing address
1732 KINGSRIDGE RD, CARROLLTON, KY 41008-8655
(502) 732-9938
(502) 732-9938
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/01/2008
Last updated
06/01/2008
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