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General NPI Number Information
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NPI Number | 1932661972
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Entity Type | Organization
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Legal Business Name | VISION QUEST RECOVERY LLC
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Dates
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Enumeration Date | 04/01/2019
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Last Update Date | 04/01/2019
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Provider Practice Location Address
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Address Line | 32890 KILLEWALD ST
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City | CHESTERFIELD
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State | MI
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Zip | 48047-3308
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Country | US
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Telephone | 248-421-8143
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Fax | 586-719-1449
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Provider Business Mailing Address
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Address Line | 32890 KILLEWALD ST
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City | CHESTERFIELD
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State | MI
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Zip | 48047-3308
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Country | US
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Telephone | 248-421-8143
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Fax | 586-719-1449
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHARD ARTHUR KROLL JR.
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Credential |
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Telephone | 248-421-8143
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number |
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License Number State |
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