Provision Home
NPI #1730950072 in West Liberty, Kentucky
Provider Information
- NPI Number
- 1730950072
- Entity Type
- Organization
- Organization Name
- Provision Home
- Primary Specialty
- Peer Specialist
- Enumeration Date
- Jan 15, 2024
- Last Updated
- Jan 15, 2024
Practice Location
- Address
- 778 BROADWAY ST
- City
- West Liberty
- State
- Kentucky
- ZIP Code
- 41472-1110
- Phone
- (606) 923-0361
Authorized Official
- Name
- DAVID BRIAN BARTLEY, APSS
- Title
- DIRECTOR
- Phone
- (606) 923-0361
Specialties & Taxonomy Codes
| Specialty |
|---|
| Peer Specialist |
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