Organization · Type 2 NPI

Renew Addiction Treatment Center

Addiction Medicine (Family Medicine) Physician · Pikeville, KY

NPI number 1063810091 Active

Practice location

400 Venters Ln Ste 100
Pikeville, KY 41501-3016

Call (606) 653-1505 Map

Mailing address

PO Box 1285
Pikeville, KY 41502-1285

Specialties and licenses

Taxonomy	Code	License
Addiction Medicine (Family Medicine) Physician Primary	207QA0401X	740318 (KY)
Addiction Medicine (Internal Medicine) Physician	207RA0401X	740318 (KY)
Addiction Medicine (Psychiatry & Neurology) Physician	2084A0401X	740318 (KY)

Addiction Medicine (Family Medicine) Physician: A family medicine physician who specializes in the diagnosis and treatment of addictions.

Another provider at this address

Phoenix Treatment Centers Outpatient Division, LLCSubstance Use Disorder Rehabilitation Clinic/Center Pikeville, KY NPI 1699551754

Other addiction medicine (family medicine) physician providers in Pikeville

See all in Pikeville →

NPI record

NPI: 1063810091
Entity type: Organization (Type 2)
Issued: Dec 8, 2014
Last updated: Sep 9, 2022
Status: Active
Subpart: Yes of Adapt

Other names

<unavail>
Behavioral Health Professionals · doing business as
Renew Atc · doing business as

Authorized official

Mrs. Amber Sisco
Managing Member
(606) 653-1505

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1063810091

Renew Addiction Treatment Center's National Provider Identifier is 1063810091, issued on Dec 8, 2014. The primary taxonomy on file is Addiction Medicine (Family Medicine) Physician (207QA0401X), and the practice location is in Pikeville, KY. The record was last updated on Sep 9, 2022.