PORT45 RECOVERY LLC NPI 1053944033

NPI Information

NPI: 1053944033
Provider Name: PORT45 RECOVERY LLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

CLIA Number: 36D2151279

Address:
1907 11TH ST
PORTSMOUTH, OH
ZIP 45662
Phone: (740) 529-7356
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PORT45 RECOVERY LLC is a mental health counselor in Portsmouth, OH. PORT45 RECOVERY LLC NPI is 1053944033. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1907 11TH ST
PORTSMOUTH, OH
ZIP 45662-531
Phone: (740) 529-7356

The provider's authorized official is Bryan Mcbride .
The authorized official title is Financial Executive and has the following contact phone number (614) 591-4710.

The CLIA number assigned to this NPI record is 36D2151279 - other - substance abuse trtmt with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/18/2020 and was last updated on 2/18/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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	101YM0800X	Counselor	Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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