Provider Demographics
NPI:1568114262
Name:PEER RECOVERY & THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:PEER RECOVERY & THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-551-1266
Mailing Address - Street 1:10 HALE ST FL 4
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-2830
Mailing Address - Country:US
Mailing Address - Phone:304-544-5453
Mailing Address - Fax:304-841-0688
Practice Address - Street 1:10 HALE ST FL 4
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-2830
Practice Address - Country:US
Practice Address - Phone:304-544-5453
Practice Address - Fax:304-841-0688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-24
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care