Healthcare Provider Details

I. General information

NPI: 1912553959
Provider Name (Legal Business Name): EASTERN POINT OF RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2019
Last Update Date: 03/22/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 HAGER BR
EAST POINT KY
41216-8766
US

IV. Provider business mailing address

253 HAGER BR
EAST POINT KY
41216-8766
US

V. Phone/Fax

Practice location:
  • Phone: 615-336-4148
  • Fax:
Mailing address:
  • Phone: 615-336-4148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MELANIE M HUFFINE
Title or Position: PRESIDENT
Credential:
Phone: 611-533-6414