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NPI Code Detail

MEDICARE: MOMENTUM RECOVERY LLC

MEDICARE: MOMENTUM RECOVERY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation FacilityMHL-065-257NC

General Provider Information

NPI Number : 1750822847
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOMENTUM RECOVERY LLC
Provider Business Mailing Address
First Line : 5027 WRIGHTSVILLE AVE
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-7046
Country : US
Telephone Number : 828-772-6121
Fax Number :
Provider Business Practice Location Address
First Line : 5027 WRIGHTSVILLE AVE
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-7046
Country : US
Telephone Number : 888-815-5502
Fax Number :
Authorized Official
Title or Position : CEO/CLINCAL DIRECTOR
Name : MR. RICK BARNEY
Credential : LCSW, LCAS, MAC, CCS
Telephone Number : 828-772-6121
Provider Enumeration Date : 03/09/2017
Last Update Date : 06/21/2022

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