Provider Demographics
NPI:1114067410
Name:FAMILY RECOVERY, INC.
Entity Type:Organization
Organization Name:FAMILY RECOVERY, INC.
Other - Org Name:MILESTONES FAMILY RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OUTPATIENT PROGRAM MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CADC II
Authorized Official - Phone:541-757-7534
Mailing Address - Street 1:442 NW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-6491
Mailing Address - Country:US
Mailing Address - Phone:541-738-6832
Mailing Address - Fax:541-738-6410
Practice Address - Street 1:442 NW 4TH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-6491
Practice Address - Country:US
Practice Address - Phone:541-738-6832
Practice Address - Fax:541-738-6410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA-159101YA0400X
324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityGroup - Single Specialty