Provider Demographics
NPI:1164828091
Name:HUBBARD RECOVERY,LLC
Entity Type:Organization
Organization Name:HUBBARD RECOVERY,LLC
Other - Org Name:164 COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-678-0078
Mailing Address - Street 1:506 HICKORY AVE
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:TX
Mailing Address - Zip Code:76648-2224
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 NORTH 5TH STREET
Practice Address - Street 2:SUITE A
Practice Address - City:HUBBARD
Practice Address - State:TX
Practice Address - Zip Code:76648
Practice Address - Country:US
Practice Address - Phone:954-678-0078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3775-3776261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder