Provider Demographics
NPI:1568667640
Name:ARCHWAY RECOVERY CENTERS, INC
Entity Type:Organization
Organization Name:ARCHWAY RECOVERY CENTERS, INC
Other - Org Name:ARCHWAY RECOVERY CENTERS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARION
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-896-2724
Mailing Address - Street 1:144 FAIRWAY DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-6455
Mailing Address - Country:US
Mailing Address - Phone:830-896-2724
Mailing Address - Fax:830-896-2746
Practice Address - Street 1:144 FAIRWAY DR
Practice Address - Street 2:SUITE C
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-6455
Practice Address - Country:US
Practice Address - Phone:830-896-2724
Practice Address - Fax:830-896-2746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2545A261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID