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Organization

BOULWARE MISSION INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SHANE SHERIFF LCADC, LPCC, CCS (CLINICAL DIRECTOR)
(270) 683-8267
Entity
Organization

Contact information

Practice address
609 WING AVE, OWENSBORO, KY 42303-0408
(270) 683-8267
Mailing address
609 WING AVE, OWENSBORO, KY 42303-0408
(270) 683-8267

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
01/13/2026
Last updated
01/13/2026
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