Provider Demographics
NPI:1053692012
Name:AWARENESS AND DISCOVERY GROUP LLC
Entity type:Organization
Organization Name:AWARENESS AND DISCOVERY GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:N
Authorized Official - Last Name:HAMM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:859-525-1487
Mailing Address - Street 1:2 DORTHA AVE
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-2014
Mailing Address - Country:US
Mailing Address - Phone:859-525-1487
Mailing Address - Fax:859-525-7811
Practice Address - Street 1:2 DORTHA AVE
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-2014
Practice Address - Country:US
Practice Address - Phone:859-525-1487
Practice Address - Fax:859-525-7811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-06
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health