Healthcare Provider Details

I. General information

NPI: 1538408000
Provider Name (Legal Business Name): ARNITA PITTMAN COMMUNITY RECOVERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2013
Last Update Date: 02/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1461 MARION WALDO RD UNIT # 240
MARION OH
43302-7421
US

IV. Provider business mailing address

1461 MARION WALDO RD UNIT # 240
MARION OH
43302-7421
US

V. Phone/Fax

Practice location:
  • Phone: 740-386-2000
  • Fax:
Mailing address:
  • Phone: 740-386-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. ARNITA DENIECE PITTMAN
Title or Position: EXECUTIVE DIRECTOR
Credential: LICDC
Phone: 740-386-2000