MEDICARE: HARMONY ROAD RECOVERY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YP2500X	Professional Counselor
3	104100000X	Social Worker
4	1041C0700X	Clinical Social Worker
5	251S00000X	Community/Behavioral Health Agency
6	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
7	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1952022337
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARMONY ROAD RECOVERY LLC

Provider Business Mailing Address
First Line	:	813 N KANSAS ST STE 200
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-5218
Country	:	US
Telephone Number	:	915-271-8971
Fax Number	:	915-900-5478

Provider Business Practice Location Address
First Line	:	813 N KANSAS ST STE 200
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-5218
Country	:	US
Telephone Number	:	915-271-8971
Fax Number	:	915-900-5478

Authorized Official
Title or Position	:	OWNER
Name	:	HANK COHN
Credential	:
Telephone Number	:	845-661-0708

Provider Enumeration Date	:	09/06/2022
Last Update Date	:	07/13/2023

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