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NPI Code Detail

MEDICARE: DAYMARK RECOVERY SERVICES INC

MEDICARE: DAYMARK RECOVERY SERVICES INC
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
12084P0800XPsychiatry Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720296403
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAYMARK RECOVERY SERVICES INC
Provider Business Mailing Address
First Line : 284 EXECUTIVE PARK DRIVE
Second Line : SUITE 100
City : CANNON
State : NC
Zip : 28025-1894
Country : US
Telephone Number : 704-939-1100
Fax Number : 704-939-1173
Provider Business Practice Location Address
First Line : 701 W ROOSEVELT BLVD
Second Line : STE 600
City : MONROE
State : NC
Zip : 28112-4106
Country : US
Telephone Number : 704-296-6200
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. BILLY R WEST JR.
Credential : L.C.S.W.
Telephone Number : 704-939-1100
Provider Enumeration Date : 05/18/2007
Last Update Date : 06/21/2023

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Directions to “DAYMARK RECOVERY SERVICES INC ” Practice Location

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