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

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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
1 NPI 1902156003
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name RECOVERY ASSOCIATES INC.
5 Provider Other Organization Name SELFREFIND OF OHIO
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 4312 OLD SCIOTO TRL
8 Provider Business Practice Location Address City Name PORTSMOUTH
9 Provider Business Practice Location Address State Name OH
10 Provider Business Practice Location Address Postal Code 456626642
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 8592367913
13 Provider Enumeration Date 9/16/2012
14 Last Update Date 9/16/2012
15 Authorized Official Last Name DURHAM
16 Authorized Official First Name JAMIE
17 Authorized Official Title or Position PRESIDENT
18 Authorized Official Telephone Number 8596056390
19 Healthcare Provider Taxonomy Code 1 101YA0400X
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: 7/15/2014
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