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General NPI Number Information
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NPI Number | 1194495002
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Entity Type | Organization
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Legal Business Name | FAITHFUL RECOVERY
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Dates
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Enumeration Date | 09/14/2021
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 224 E MAIN ST
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City | MOREHEAD
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State | KY
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Zip | 40351-2116
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Country | US
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Telephone | 606-548-1728
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Fax |
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Provider Business Mailing Address
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Address Line | 226 N WILSON AVE
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City | MOREHEAD
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State | KY
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Zip | 40351-1258
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Country | US
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Telephone | 606-548-1728
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE BARKER
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Credential |
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Telephone | 606-548-1728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 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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