Provider Demographics
NPI:1992375828
Name:APPALACHIAN MENTAL HEALTH AND ADDICTION RECOVERY
Entity Type:Organization
Organization Name:APPALACHIAN MENTAL HEALTH AND ADDICTION RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARGO
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:606-546-0053
Mailing Address - Street 1:4671 S US HIGHWAY 25E
Mailing Address - Street 2:
Mailing Address - City:BIMBLE
Mailing Address - State:KY
Mailing Address - Zip Code:40915-6112
Mailing Address - Country:US
Mailing Address - Phone:606-546-0053
Mailing Address - Fax:606-545-0497
Practice Address - Street 1:4671 S US HIGHWAY 25E
Practice Address - Street 2:
Practice Address - City:BIMBLE
Practice Address - State:KY
Practice Address - Zip Code:40915-6112
Practice Address - Country:US
Practice Address - Phone:606-546-0053
Practice Address - Fax:606-545-0497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty