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General NPI Number Information
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NPI Number | 1316597537
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Entity Type | Organization
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Legal Business Name | RECOVERY FOR THE CITY INTERNATIONAL INC.
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Dates
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Enumeration Date | 09/19/2019
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Last Update Date | 06/25/2020
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Provider Practice Location Address
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Address Line | 228 N LYNNHAVEN RD STE 118
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-7514
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Country | US
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Telephone | 757-456-0093
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Fax | 757-456-0875
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Provider Business Mailing Address
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Address Line | PO BOX 2546
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City | VIRGINIA BEACH
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State | VA
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Zip | 23450-2546
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Country | US
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Telephone | 757-340-3489
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Fax | 757-340-4278
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | PAUL ALLEN HARDY
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Credential | CSAC, MAD
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Telephone | 757-456-0093
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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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