Provider Demographics
NPI:1205220563
Name:AT PROJECT KENSINGTON
Entity Type:Organization
Organization Name:AT PROJECT KENSINGTON
Other - Org Name:JOURNEYPURE KENSINGTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICIER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-472-3728
Mailing Address - Street 1:115 PENN WARREN DR
Mailing Address - Street 2:SUITE 300-290
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5047
Mailing Address - Country:US
Mailing Address - Phone:615-727-8386
Mailing Address - Fax:615-457-8094
Practice Address - Street 1:1410 KENSINGTON SQUARE CT
Practice Address - Street 2:SUITE 104
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-6902
Practice Address - Country:US
Practice Address - Phone:615-203-3761
Practice Address - Fax:615-203-3763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNI000000016002324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility