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General NPI Number Information
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NPI Number | 1205560067
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Entity Type | Organization
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Legal Business Name | PERSONAL RESPONSIBILITY RECOVERY
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Dates
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Enumeration Date | 07/15/2022
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Last Update Date | 07/15/2022
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Provider Practice Location Address
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Address Line | 738 COUNTY ROAD 304
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City | BERTRAM
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State | TX
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Zip | 78605-3936
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Country | US
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Telephone | 737-356-3731
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Fax |
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Provider Business Mailing Address
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Address Line | 362 OLD WILDCATTERS RD
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City | LIBERTY HILL
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State | TX
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Zip | 78642-4649
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Country | US
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Telephone | 737-356-3731
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARC MEYERS
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Credential |
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Telephone | 512-589-2661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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