MEDICARE: ADDICTION RECOVERY CARE ASSOCIATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility	MHL 034004	NC
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1013969922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADDICTION RECOVERY CARE ASSOCIATION

Provider Business Mailing Address
First Line	:	5755 SHATTALON DR
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27105-1332
Country	:	US
Telephone Number	:	336-784-9470
Fax Number	:	336-784-9505

Provider Business Practice Location Address
First Line	:	5755 SHATTALON DR
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27105-1332
Country	:	US
Telephone Number	:	336-784-9470
Fax Number	:	336-784-9505

Authorized Official
Title or Position	:	CEO
Name	:	MS. KAREN TAYLOR HOLDEN
Credential	:	MPA
Telephone Number	:	336-784-9470

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	02/12/2026

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