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General NPI Number Information
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NPI Number | 1467871699
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Entity Type | Organization
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Legal Business Name | RECYCLED RECOVERY COUNSELING SERVICES
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 04/15/2014
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Provider Practice Location Address
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Address Line | 13287 SANDALWOOD DR
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City | FRANKLINTON
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State | LA
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Zip | 70438-4599
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Country | US
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Telephone | 985-839-6900
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Fax | 985-839-9963
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Provider Business Mailing Address
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Address Line | 13287 SANDALWOOD DR
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City | FRANKLINTON
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State | LA
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Zip | 70438-4599
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Country | US
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Telephone | 985-839-6900
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Fax | 985-839-9963
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. KERA E MOSELEY
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Credential | DR.PH, LLC, CCS
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Telephone | 985-839-6900
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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 | 1418
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License Number State | LA
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