Organization
ALCOHOL AND SUBSTANCE ABUSE PROFESSIONALS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EUGENE SISCO III (ADMINISTRATOR)
(606) 437-0097
Entity
Organization
Contact information
Practice address
118 CAROLINE AVE, SUITE 2, PIKEVILLE, KY 41501-3988
(606) 437-0097
(606) 657-0205
Mailing address
118 CAROLINE AVE, SUITE 2, PIKEVILLE, KY 41501-3988
(606) 437-0097
(606) 657-0205
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
810148
KY
Other
Enumeration date
01/15/2014
Last updated
01/15/2014
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