Healthcare Provider Details

I. General information

NPI: 1609215839
Provider Name (Legal Business Name): VANCE RECOVERY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2013
Last Update Date: 03/05/2020
Certification Date: 03/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 DABNEY DR STE B
HENDERSON NC
27536-3946
US

IV. Provider business mailing address

PO BOX 135
HENDERSON NC
27536-0135
US

V. Phone/Fax

Practice location:
  • Phone: 252-572-2625
  • Fax: 252-572-2625
Mailing address:
  • Phone: 252-572-2625
  • Fax: 252-572-2955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIC D MORSE
Title or Position: PROGRAM SPONSOR/MEDICAL DIRECTOR
Credential: MD
Phone: 919-673-9681