Healthcare Provider Details

I. General information

NPI: 1508287764
Provider Name (Legal Business Name): DARKE COUNTY RECOVERY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2013
Last Update Date: 11/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 E MAIN ST
GREENVILLE OH
45331-1913
US

IV. Provider business mailing address

600 WALNUT ST
GREENVILLE OH
45331-1944
US

V. Phone/Fax

Practice location:
  • Phone: 937-548-1635
  • Fax: 937-548-1500
Mailing address:
  • Phone: 937-548-6842
  • Fax: 937-548-8938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA COOK
Title or Position: EXECUTIVE DIRECTOR
Credential: LICDC-CSPSY. D.
Phone: 937-548-6842