Organization
ODYSSEY INC
Active
Other names
Lydia's House
Organization subpart
No
Provider details
NPI number
Authorized official
CHEYENNA RUNYON (DIRECTOR OF CREDENTIALING)
(606) 638-0938
Entity
Organization
Contact information
Practice address
185 MAGGARD STREET, BENHAM, KY 40807
(606) 638-0938
Mailing address
PO BOX 686, LOUISA, KY 41230-0686
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
810328
AODE
KY
Enumeration date
07/12/2019
Last updated
12/16/2024
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