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General NPI Number Information
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NPI Number | 1205345725
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Entity Type | Organization
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Legal Business Name | HEALTHY LIVING RECOVERY SERVICES LLC
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Dates
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Enumeration Date | 09/27/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2525 WALDEN GLEN CIR APT A
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City | CINCINNATI
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State | OH
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Zip | 45231-1441
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Country | US
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Telephone | 513-616-7442
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Fax |
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Provider Business Mailing Address
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Address Line | 2525 WALDEN GLEN CIR APT A
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City | CINCINNATI
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State | OH
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Zip | 45231-1441
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Country | US
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Telephone | 513-616-7442
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Fax |
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Authorized Official
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Title or Position | OWNER/LICENSED SOCIAL WOER
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Name | DIONDRA ROSE HOLLIDAY
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Credential | LSW
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Telephone | 513-616-7442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health 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 | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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License Number | S1440334
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License Number State | OH
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