Provider Demographics
NPI:1023186293
Name:FAMILY RECOVERY INC
Entity Type:Organization
Organization Name:FAMILY RECOVERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HOLSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:770-535-1073
Mailing Address - Street 1:703 GROVE STREET
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501
Mailing Address - Country:US
Mailing Address - Phone:770-535-1073
Mailing Address - Fax:770-287-1931
Practice Address - Street 1:703 GROVE STREET
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501
Practice Address - Country:US
Practice Address - Phone:770-535-1073
Practice Address - Fax:770-287-1931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty