RECOVERY ASSOCIATES INC. (SELFREFIND OF OHIO) - NPI NUMBER 1902156003

Summary

Provider Name: RECOVERY ASSOCIATES INC. (SELFREFIND OF OHIO)

NPI Number: 1902156003

Clasification: Counselor (101YA0400X)

Specialization: Addiction (Substance Use Disorder)

Address:
4312 OLD SCIOTO TRL
PORTSMOUTH, OH
ZIP 45662

Phone Number: (859) 236-7913



Detailed Information

RECOVERY ASSOCIATES INC. is an addiction counselor in Portsmouth, OH. The assigned NPI number for this provider is 1902156003 and is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Selfrefind Of Ohio.

The provider's business address is:

4312 OLD SCIOTO TRL
PORTSMOUTH, OH
ZIP 45662-642
Phone: (859) 236-7913

The provider's authorized official is Jamie Durham .
The authorized official title is President and has the following contact phone number (859) 605-6390.

The enumeration date for this NPI number is 9/16/2012 and was last updated on 9/16/2012.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 101YA0400X Counselor Addiction (Substance Use Disorder) Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1902156003 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name RECOVERY ASSOCIATES INC. The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider Other Organization Name SELFREFIND OF OHIO Other name by which the organization provider is or has been known.
6 Provider Other Organization Name Type Code 3 Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
7 Provider First Line Business Practice Location Address 4312 OLD SCIOTO TRL The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Business Practice Location Address City Name PORTSMOUTH The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name OH The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 456626642 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 8592367913 The telephone number associated with the location address of the provider being identified.
13 Provider Enumeration Date 9/16/2012 The date the provider was assigned a unique identifier (assigned an NPI).
14 Last Update Date 9/16/2012 The date that a record was last updated or changed.
15 Authorized Official Last Name DURHAM The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
16 Authorized Official First Name JAMIE The first name of the authorized official.
17 Authorized Official Title or Position PRESIDENT The title or position of the authorized official.
18 Authorized Official Telephone Number 8596056390 The 10-position telephone number of the authorized official.
19 Healthcare Provider Taxonomy Code 1 101YA0400X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Is Organization Subpart N
22 Authorized Official Credential Text PRESIDENT
23 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

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This page was last updated on: 4/19/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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