Healthcare Provider Details

I. General information

NPI: 1447968797
Provider Name (Legal Business Name): SETTLERS LANDING RECOVERY, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 11/07/2022
Certification Date: 11/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

491 W MAIN ST
FRIES VA
24330-4499
US

IV. Provider business mailing address

1002 SADDLE CREEK RD
INDEPENDENCE VA
24348-4443
US

V. Phone/Fax

Practice location:
  • Phone: 713-859-6309
  • Fax:
Mailing address:
  • Phone: 713-859-6309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State

VIII. Authorized Official

Name: MR. BRIAN GEOFFREY EDENFIELD
Title or Position: MANAGER
Credential: BBA, MBA
Phone: 713-859-6309