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General NPI Number Information
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NPI Number | 1669049532
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Entity Type | Organization
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Legal Business Name | ASCENT RECOVERY SOLUTIONS LLC
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Dates
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Enumeration Date | 06/08/2021
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 634 FAIRVIEW RD BLDG I
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City | SIMPSONVILLE
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State | SC
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Zip | 29680-6707
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Country | US
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Telephone | 864-228-7788
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Fax | 864-757-8680
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Provider Business Mailing Address
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Address Line | 634 FAIRVIEW RD BLDG I
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City | SIMPSONVILLE
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State | SC
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Zip | 29680-6707
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Country | US
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Telephone | 864-228-7788
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Fax | 864-757-8680
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Authorized Official
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Title or Position | PROGRAM SPONSOR/MANAGING PARTNER
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Name | DONALD VIETS
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Credential | PHARMD
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Telephone | 910-770-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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