Organization
MANCHESTER MIRACLES RECOVERY CENTER, LLC
Active
Other names
Bluegrass Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
DUSTIN B PHILLIPS M.S., LCADC, CAIMHP (CLINICAL DIRECTOR)
(606) 595-3218
Entity
Organization
Contact information
Practice address
1249 S MAIN ST STE 3, LONDON, KY 40741-2004
(606) 595-3218
(606) 215-8372
Mailing address
26 SCARLET DR, CORBIN, KY 40701-8070
(606) 595-3218
(606) 215-8372
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
03/01/2025
Last updated
05/10/2026
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