BROOKSIDE – NPI #1760846232
Substance Abuse Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

BROOKSIDE is a substance abuse rehabilitation facility located in PIKEVILLE, KY. NPPES has assigned the NPI number 1760846232 to BROOKSIDE on April 11, 2016. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “BROOKSIDE” is a dba name, the actual legal business name for this organization is RENEW RESIDENTIAL TREATMENT SERVICES. The primary taxonomy selected by this provider is 324500000X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility.

The NPI profile was previously updated about 3 years ago on Apr 18, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BROOKSIDE below.

NPI Profile for
RENEW RESIDENTIAL TREATMENT SERVICES

NPI Number
1760846232
Enumeration Date

(more than 10 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
RENEW RESIDENTIAL TREATMENT SERVICES
Doing Business As (dba): BROOKSIDE
Primary location
400 VENTERS LN
PIKEVILLE, KY 41501-3016
Phone: (606) 653-1874 Fax:
Mailing address
PO BOX 1285
PIKEVILLE, KY 41502-1285
Phone: (606) 658-3078 Fax: (606) 773-1011
Organization Subpart
No
Authorized Official
AMBER SISCO
OWNER
Phone: (606) 658-3078
Updated
Certification Date
Apr 18, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for BROOKSIDE

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidKY7100851810
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
324500000X
- Substance Abuse Rehabilitation Facility (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.