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General NPI Number Information
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NPI Number | 1205963378
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Entity Type | Organization
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Legal Business Name | WASHINGTON COUNTY RECOVERY ALTERNATIVES
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 200 PUTNAM ST SUITE 728
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City | MARIETTA
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State | OH
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Zip | 45750-3005
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Country | US
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Telephone | 740-568-0733
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Fax | 740-376-9736
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Provider Business Mailing Address
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Address Line | 200 PUTNAM ST SUITE 728
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City | MARIETTA
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State | OH
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Zip | 45750-3005
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Country | US
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Telephone | 740-568-0733
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Fax | 740-376-9736
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. RAY W STATHERS
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Credential | LISW
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Telephone | 740-568-0733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 10365
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License Number State | OH
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