Healthcare Provider Details

I. General information

NPI: 1841344611
Provider Name (Legal Business Name): DARKE COUNTY RECOVERY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 11/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 WALNUT ST
GREENVILLE OH
45331-1944
US

IV. Provider business mailing address

600 WALNUT ST
GREENVILLE OH
45331-1944
US

V. Phone/Fax

Practice location:
  • Phone: 937-548-6842
  • Fax: 937-548-8938
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 Number02546
License Number StateOH

VIII. Authorized Official

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