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General NPI Number Information
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NPI Number | 1548054810
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Entity Type | Organization
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Legal Business Name | LINCOLN RECOVERY LLC
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Dates
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Enumeration Date | 04/09/2025
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 19130 W FRONTAGE RD
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City | RAYMOND
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State | IL
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Zip | 62560-5052
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Country | US
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Telephone | 217-471-5816
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Fax |
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Provider Business Mailing Address
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Address Line | 2955 E 1ST AVE STE 200
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City | DENVER
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State | CO
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Zip | 80206-5636
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF COMPLIANCE
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Name | STEPHEN VANHOOSER
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Credential |
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Telephone | 949-750-2014
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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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