Provider Demographics
NPI:1801296314
Name:THE COMMITMENT HOUSE LLC
Entity type:Organization
Organization Name:THE COMMITMENT HOUSE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-300-6565
Mailing Address - Street 1:PO BOX 1086
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42702-1086
Mailing Address - Country:US
Mailing Address - Phone:270-900-0373
Mailing Address - Fax:270-900-0246
Practice Address - Street 1:723 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-1063
Practice Address - Country:US
Practice Address - Phone:270-900-0373
Practice Address - Fax:270-900-0426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-03
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY18505324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100413250Medicaid