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General NPI Number Information
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NPI Number | 1912694795
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Entity Type | Organization
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Legal Business Name | MARY HUNTERS RECOVERY GROUP
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Dates
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Enumeration Date | 04/20/2023
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 431 S BROADWAY STE 123
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City | LEXINGTON
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State | KY
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Zip | 40508-2955
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Country | US
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Telephone | 859-785-3804
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Fax | 877-897-8103
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Provider Business Mailing Address
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Address Line | 4156 WESTPORT RD STE 214
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City | LOUISVILLE
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State | KY
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Zip | 40207-2705
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Country | US
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Telephone | 859-309-8552
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Fax | 859-800-0342
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Authorized Official
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Title or Position | OWNER
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Name | RAYSHAWN HUNTER
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Credential |
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Telephone | 859-363-5909
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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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Taxonomy #2
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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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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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