LAKE CUMBERLAND RECOVERY, INC (NPI# 1902442585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902442585 |
| Entity Type | Organization |
| Organization Name | LAKE CUMBERLAND RECOVERY, INC |
| Practice Address |
8294 S Highway 27 Burnside KY 42519-9412 |
| Mailing Address |
505 Wondering Woods Somerset KY 42053 |
| Practice Telephone | 6065169939 |
| Mailing Telephone | 6065169939 |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2019-11-19 |
| Authorized Official Name | MR. MIKKLE LEE HAMPTON (PRESIDENT) |
| Authorized Official Telephone | 6065169939 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013553247 | Lake Cumberland Recovery, Inc | Substance Abuse Rehabilitation Facility | 8294 S Highway 27, Burnside, KY 42519-9412 | 2019-11-22 |
| Street Address |
8294 S HIGHWAY 27 |
| City | BURNSIDE |
| State | KY |
| Zip Code | 42519-9412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700400926 | Lori Beth Stogsdill | Registered Nurse | 8294 S Highway 27, Burnside, KY 42519-9412 | 2020-06-03 |
| 1013553247 | Lake Cumberland Recovery, Inc | Substance Abuse Rehabilitation Facility | 8294 S Highway 27, Burnside, KY 42519-9412 | 2019-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134564966 | Morgan Coffey | Student in an Organized Health Care Education/Training Program | 623 West Lakeshore Dr, Burnside, KY 42519 | 2013-05-07 |
| 1255462727 | Lewis Martin Misinay | Chiropractor | 8034 S. Hwy 27, Burnside, KY 42519 | 2007-03-08 |
| 1851320931 | Lakeshore Pharmacy Inc. | Pharmacist | 51 W Lakeshore Dr, Burnside, KY 42519-9424 | 2006-07-01 |
| 1548304868 | Lake Cumberland District Health Dept | Public Health or Welfare | 435 E Lakeshore Dr, Burnside, KY 42519-9454 | 2007-02-19 |
| 1427204205 | Burnside Chiropractic | Chiropractor | 8034 S Highway 27, Burnside, KY 42519-9717 | 2008-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134564966 | Morgan Coffey | Student in an Organized Health Care Education/Training Program | 623 West Lakeshore Dr, Burnside, KY 42519 | 2013-05-07 |
| 1194041939 | Valeri Kay Dittmer | Speech-Language Pathologist | 2330 E County Road 1950, Burnside, IL 62330-5335 | 2010-04-19 |
| 1427204205 | Burnside Chiropractic | Chiropractor | 8034 S Highway 27, Burnside, KY 42519-9717 | 2008-08-13 |
| 1548453137 | Southeast Webster-grand Community School District | Local Education Agency (LEA) | 30850 Paragon Ave, Burnside, IA 50521-0049 | 2007-08-27 |
| 1255462727 | Lewis Martin Misinay | Chiropractor | 8034 S. Hwy 27, Burnside, KY 42519 | 2007-03-08 |
| 1548304868 | Lake Cumberland District Health Dept | Public Health or Welfare | 435 E Lakeshore Dr, Burnside, KY 42519-9454 | 2007-02-19 |
| 1851320931 | Lakeshore Pharmacy Inc. | Pharmacist | 51 W Lakeshore Dr, Burnside, KY 42519-9424 | 2006-07-01 |
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1194295089 | Freedom Bridge To Recovery LLC | Clinic/Center | 1307 Magnolia St, Bowling Green, KY 42104-3050 | 2018-12-04 |
| 1619450186 | Pax House Inc. | Clinic/Center | 2305 Hurstbourne Village Dr Ste 600, Louisville, KY 40299-2875 | 2018-09-11 |
| 1063999761 | Landmark Recovery Outpatient Services LLC | Clinic/Center | 4112 Fern Valley Rd Ste B, Louisville, KY 40219-1973 | 2018-07-25 |
| 1144723453 | Rose of Sharon House | Clinic/Center | 865 W Shelby St, Junction City, KY 40440-8502 | 2018-03-13 |
| 1477062487 | New Legacy Recovery LLC | Clinic/Center | 1510 Newtown Pike Ste 120, Lexington, KY 40511-1255 | 2017-09-21 |
| 1710426960 | The Liberty Ranch Rehabilitation Center | Clinic/Center | 2735 Ky Highway 501, Kings Mountain, KY 40442-9761 | 2017-02-21 |
| 1114389822 | Pinnacle Treatment Centers Ky-i, LLC | Clinic/Center | 100 E Broadway # 105-107, Mayfield, KY 42066-2329 | 2016-03-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.