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General NPI Number Information
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NPI Number | 1275589178
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Entity Type | Organization
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Legal Business Name | PIKE COUNTY RECOVERY COUNCIL INC
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | 14572 US HIGHWAY 23
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City | WAVERLY
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State | OH
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Zip | 45690-9373
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Country | US
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Telephone | 740-947-6727
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Fax | 740-947-6917
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Provider Business Mailing Address
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Address Line | P.O. BOX 226
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City | WAVERLY
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State | OH
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Zip | 45690-0226
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Country | US
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Telephone | 740-947-6727
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Fax | 740-947-6917
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Authorized Official
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Title or Position | DEPUTY DIRECTOR
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Name | VERONICA MICHELLE BLACK
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Credential | CDCA
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Telephone | 740-947-6727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 527733
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License Number State | OH
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