OrganizationActive
Supportive Roads Mentoring Program Incorporated
NPI 1114691409 · Voluntary or Charitable Agency · Bowling Green, KY
Provider details
- NPI number
- 1114691409
- Entity type
- Organization
- Primary specialty
- Voluntary or Charitable AgencyAgencies
- Organization subpart
- No
- Authorized official
- Cynthia Mackey, Ceo(270) 599-1034
Specialties & taxonomies
Agencies
Practice location
901 Beauty Ave
Bowling Green, KY 42101-6135
Phone: (270) 599-1034
Fax: (270) 599-1035
Approximate (ZIP-level) locationGet directions
Mailing address
901 Beauty Ave
Bowling Green, KY 42101-6135
Registry dates
- Enumerated
- 2021-08-02
- Last updated
- 2025-09-11
- Certified
- 2021-08-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.