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NPI Code Detail

MEDICARE: FIRST CAPITAL RECOVERY AND COUNSELING, LLC

MEDICARE: FIRST CAPITAL RECOVERY AND COUNSELING, 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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2343900000XNon-emergency Medical Transport (VAN)

General Provider Information

NPI Number : 1821759200
Entity Type Code : Organization
Provider Name (Legal Business Name) : FIRST CAPITAL RECOVERY AND COUNSELING, LLC
Provider Business Mailing Address
First Line : 50 W MAIN ST
Second Line :
City : CHILLICOTHEE
State : OH
Zip : 45601-3103
Country : US
Telephone Number : 740-773-3272
Fax Number :
Provider Business Practice Location Address
First Line : 50 W MAIN ST
Second Line :
City : CHILLICOTHEE
State : OH
Zip : 45601-3103
Country : US
Telephone Number : 740-773-3272
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. CHESTER LYTLE
Credential :
Telephone Number : 740-703-6075
Provider Enumeration Date : 01/06/2022
Last Update Date : 01/06/2022

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Directions to “FIRST CAPITAL RECOVERY AND COUNSELING, LLC ” Practice Location

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