MEDICARE: BLUEPRINTS FOR ADDICTION RECOVERY

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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1447614698
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUEPRINTS FOR ADDICTION RECOVERY

Provider Business Mailing Address
First Line	:	1901 OLDE HOMESTEAD LN
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17601-5824
Country	:	US
Telephone Number	:	717-361-1660
Fax Number	:	717-366-4357

Provider Business Practice Location Address
First Line	:	15 MOUNT JOY ST
Second Line	:
City	:	MOUNT JOY
State	:	PA
Zip	:	17552-1417
Country	:	US
Telephone Number	:	717-361-1660
Fax Number	:	717-366-4357

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MR. JESSE HUNT SR.
Credential	:
Telephone Number	:	717-361-1660

Provider Enumeration Date	:	04/13/2016
Last Update Date	:	11/06/2023

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