Healthcare Provider Details
I. General information
NPI: 1649881822
Provider Name (Legal Business Name): SOLUTIONS RECOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/12/2020
Last Update Date: 08/12/2020
Certification Date: 08/12/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2020 W PINHOOK RD STE 504
LAFAYETTE LA
70508-3212
US
IV. Provider business mailing address
PO BOX 51104
LAFAYETTE LA
70505-1104
US
V. Phone/Fax
- Phone: 337-214-2100
- Fax: 337-284-3004
- Phone: 337-214-2100
- Fax: 337-284-3004
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
R
RICHARD
Title or Position: CEO
Credential: LAC
Phone: 337-214-2100