Provider Demographics
NPI:1255866307
Name:ROAD TO RECOVERY INC
Entity Type:Organization
Organization Name:ROAD TO RECOVERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBACEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-858-9579
Mailing Address - Street 1:9400 LOMAX ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77093-6738
Mailing Address - Country:US
Mailing Address - Phone:713-858-9579
Mailing Address - Fax:
Practice Address - Street 1:9400 LOMAX ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77093-6738
Practice Address - Country:US
Practice Address - Phone:713-858-9579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3422-3868261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder