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NPI Code Detail

MEDICARE: CLEAR PATH RECOVERY CENTER LLC

MEDICARE: CLEAR PATH RECOVERY CENTER LLC
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
1276400000XSubstance Use Disorder Rehabilitation Hospital Unit
2324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1639063258
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLEAR PATH RECOVERY CENTER LLC
Provider Business Mailing Address
First Line : 2101 N ASH ST
Second Line :
City : NEVADA
State : MO
Zip : 64772-1082
Country : US
Telephone Number : 417-392-7307
Fax Number :
Provider Business Practice Location Address
First Line : 2101 N ASH ST
Second Line :
City : NEVADA
State : MO
Zip : 64772-1082
Country : US
Telephone Number : 417-392-7307
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. TIMOTHY L DENNING JR.
Credential :
Telephone Number : 417-392-7307
Provider Enumeration Date : 06/06/2025
Last Update Date : 06/06/2025

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Directions to “CLEAR PATH RECOVERY CENTER LLC ” Practice Location

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