Provider Demographics
NPI:1598446213
Name:AMAZING OPPORTUNITIES KENTUCKY, LLC
Entity Type:Organization
Organization Name:AMAZING OPPORTUNITIES KENTUCKY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAITLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:PASCHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-207-0225
Mailing Address - Street 1:269 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351
Mailing Address - Country:US
Mailing Address - Phone:606-207-0225
Mailing Address - Fax:
Practice Address - Street 1:269 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351
Practice Address - Country:US
Practice Address - Phone:606-207-0225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health