Provider Demographics
NPI:1295357531
Name:UNBOUND TREATMENT, INC.
Entity Type:Organization
Organization Name:UNBOUND TREATMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:KLIPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-436-1284
Mailing Address - Street 1:PO BOX 623
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42629-0623
Mailing Address - Country:US
Mailing Address - Phone:720-810-6109
Mailing Address - Fax:
Practice Address - Street 1:67 HARBOR DR
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:KY
Practice Address - Zip Code:42629-8036
Practice Address - Country:US
Practice Address - Phone:502-352-2373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-09
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty