Organization
EDGEWATER TRANSITIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON ELAM (OWNER)
(606) 207-6617
Entity
Organization
Contact information
Practice address
141 E MAIN ST, MOREHEAD, KY 40351-1652
(606) 207-6617
Mailing address
PO BOX 1213, MOREHEAD, KY 40351-5213
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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