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General NPI Number Information
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NPI Number | 1023618071
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Entity Type | Organization
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Legal Business Name | RECOVERY FOUNDATIONS LLC
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Dates
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Enumeration Date | 10/29/2020
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Last Update Date | 10/29/2020
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Provider Practice Location Address
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Address Line | 1856 STONY POINT RD
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City | SHELBY
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State | NC
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Zip | 28150-9601
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Country | US
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Telephone | 704-802-4145
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 TWIN AVE
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City | GASTONIA
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State | NC
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Zip | 28052-1359
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/OWNER
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Name | DIANNE HUITT
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Credential | QP, CADC, NCCPSS,
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Telephone | 704-777-4335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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