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General NPI Number Information
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NPI Number | 1053957704
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Entity Type | Organization
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Legal Business Name | CARDINAL RECOVERY LLC
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Dates
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Enumeration Date | 11/18/2019
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 1130 W JEFFERSON ST STE B
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City | FRANKLIN
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State | IN
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Zip | 46131-2760
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Country | US
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Telephone | 561-876-1498
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Fax |
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Provider Business Mailing Address
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Address Line | 1130 W JEFFERSON ST STE B
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City | FRANKLIN
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State | IN
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Zip | 46131-2760
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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 | PROJECT MANAGER COO
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Name | DONALD HUSTON
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Credential |
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Telephone | 561-876-1498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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