Healthcare Provider Details

I. General information

NPI: 1316643604
Provider Name (Legal Business Name): RECOVERY SERVICES OF GREATER DAYTON LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2023
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3430 S DIXIE DR STE 308
MORAINE OH
45439-2316
US

IV. Provider business mailing address

2 HUNTINGTON PL
KETTERING OH
45420-2923
US

V. Phone/Fax

Practice location:
  • Phone: 937-388-3009
  • Fax:
Mailing address:
  • Phone: 937-271-3153
  • 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

VIII. Authorized Official

Name: TAYLOR ROUSTIO
Title or Position: PARTNER
Credential:
Phone: 937-388-3009