Organization · NPI-2

Central Kentucky Recovery Management

Family Medicine, Addiction Medicine · Cynthiana, KY

NPI number1619339736

StatusActive

Last updated in NPPESJun 2, 2021

Details

NPI: 1619339736
Entity type: Organization (NPI-2)
Legal business name: Central Kentucky Recovery Management
Organization subpart: No
Enumeration date: Mar 28, 2016
Certification date: Jun 2, 2021
Last updated: Jun 2, 2021

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207QA0401X	Family Medicine, Addiction Medicine	–	–	Yes
261QM1300X	Clinic/Center, Multi-Specialty	–	–
261QR1300X	Clinic/Center, Rural Health	–	–

Other names

New Life Recovery (Doing Business As)

Practice location

1094 Us Highway 27 S Ste A
Cynthiana, KY 41031-7078

Phone 859-569-3145 · Fax 859-569-3176

Mailing address

1094 Us Highway 27 S Ste A
Cynthiana, KY 41031-7078

Phone 859-569-3145 · Fax 859-569-3176

Authorized official

Tracy S Fryman
Owner
8595693145

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