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General NPI Number Information
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NPI Number | 1104776442
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Entity Type | Organization
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Legal Business Name | INDIANA RECOVERY HOMES LLC
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Dates
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Enumeration Date | 01/28/2026
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 2630 22ND ST
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City | COLUMBUS
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State | IN
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Zip | 47201-3702
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Country | US
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Telephone | 812-375-3784
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 269
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City | DELLSLOW
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State | WV
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Zip | 26531-0269
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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 | SR DIRECTOR
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Name | MORGAN HENSON
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Credential |
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Telephone | 304-503-3448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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