Provider Demographics
NPI:1407331259
Name:JOURNEY TO RECOVERY LLC
Entity Type:Organization
Organization Name:JOURNEY TO RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MILLS-MATTOX
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:832-725-0581
Mailing Address - Street 1:3443 ESPLANADE AVE APT 556
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-2967
Mailing Address - Country:US
Mailing Address - Phone:832-725-0581
Mailing Address - Fax:888-977-1299
Practice Address - Street 1:5640 READ BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-3140
Practice Address - Country:US
Practice Address - Phone:504-241-0105
Practice Address - Fax:888-977-1299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty