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1083148076
ETOWN ADDICTION SOLUTIONS, LLC
ELIZABETHTOWN, KY
NPI
1083148076
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Entity Type
Organization
Authorized Contact
BRANT MASSMAN
Sec/Treas.
208-367-9446
Organization Subpart ?
No
Primary Taxonomy
261QM2800X Clinic/Center Methadone
Enumeration Date
2017-04-17
Last Update Date
2017-04-17
Business Address
ETOWN ADDICTION SOLUTIONS, LLC
2645 LEITCHFIELD RD STE 104
ELIZABETHTOWN, KY 42701-8306
Phone number: 270-234-8180
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Mailing Address
ETOWN ADDICTION SOLUTIONS, LLC
PO BOX 897
BOISE, ID 83701-0897
Phone number: 208-367-9446
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