Organization
ETHAN HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY FENN (CFO)
(859) 317-9714
Entity
Organization
Contact information
Practice address
1623 FOXHAVEN DR, RICHMOND, KY 40475-1056
(859) 317-8714
Mailing address
1623 FOXHAVEN DR, RICHMOND, KY 40475-1056
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/04/2016
Last updated
07/31/2024
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