Healthcare Provider Details

I. General information

NPI: 1316332067
Provider Name (Legal Business Name): THE RECOVERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2015
Last Update Date: 03/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 HIGHWAY 15 S STE 200
JACKSON KY
41339-7247
US

IV. Provider business mailing address

1550 HIGHWAY 15 S STE 200
JACKSON KY
41339-7247
US

V. Phone/Fax

Practice location:
  • Phone: 606-666-6840
  • Fax: 606-666-8414
Mailing address:
  • Phone: 606-666-6840
  • Fax: 606-666-8414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. GEORGE EDWARD BURNETTE
Title or Position: OWNER
Credential: MD
Phone: 606-666-8404