Provider Demographics
NPI:1669630554
Name:ABS LINCS KY INC
Entity Type:Organization
Organization Name:ABS LINCS KY INC
Other - Org Name:CUMBERLAND HALL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT & SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-312-5700
Mailing Address - Street 1:6640 CAROTHERS PKWY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-6323
Mailing Address - Country:US
Mailing Address - Phone:615-312-5700
Mailing Address - Fax:615-312-5711
Practice Address - Street 1:210 W 17TH ST
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-1912
Practice Address - Country:US
Practice Address - Phone:270-886-1919
Practice Address - Fax:270-886-1335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY04024014Medicaid