Provider Demographics
NPI:1811558091
Name:KINDRED RECOVERY PLLC
Entity Type:Organization
Organization Name:KINDRED RECOVERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:KINDRED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-785-8585
Mailing Address - Street 1:146 DEWEESE ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40507-1921
Mailing Address - Country:US
Mailing Address - Phone:859-785-8585
Mailing Address - Fax:859-888-8890
Practice Address - Street 1:146 DEWEESE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40507-1921
Practice Address - Country:US
Practice Address - Phone:859-785-8585
Practice Address - Fax:859-888-9980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-27
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction MedicineGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty