Organization
THE LIBERTY RANCH REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY LUTTRELL (CHIEF EXECUTIVE OFFICER)
(606) 787-0424
Entity
Organization
Contact information
Practice address
2735 KY HIGHWAY 501, KINGS MOUNTAIN, KY 40442-9761
(606) 787-0424
Mailing address
2735 KY HIGHWAY 501, KINGS MOUNTAIN, KY 40442-9761
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
02/21/2017
Last updated
02/21/2017
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