Organization
TRIO COMMUNITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DREW HAYNES (OWNER)
(270) 993-4388
Entity
Organization
Contact information
Practice address
12706 CRESTMOOR CIR, PROSPECT, KY 40059-9181
(270) 993-4388
Mailing address
12706 CRESTMOOR CIR, PROSPECT, KY 40059-9181
(270) 993-4388
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17000654
—
KY
Enumeration date
05/08/2007
Last updated
08/22/2020
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