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General NPI Number Information
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NPI Number | 1720475932
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Entity Type | Organization
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Legal Business Name | RECOVERY BEHAVIORAL HEALTHCARE, LLC
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Dates
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Enumeration Date | 04/25/2015
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Last Update Date | 05/11/2016
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Provider Practice Location Address
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Address Line | 416 WEST BLVD STE 4
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City | CHESTERFIELD
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State | SC
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Zip | 29709-1507
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Country | US
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Telephone | 910-273-9956
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 542
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City | HOPE MILLS
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State | NC
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Zip | 28348-0542
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Country | US
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Telephone | 910-273-9956
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/OPERATOR
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Name | MS. BIANCO D HOLMON
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Credential | MSW
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Telephone | 910-273-9956
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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