Provider Demographics
NPI:1619013752
Name:CHEMICAL DEPENDENT EDUCATION PROGRAMS
Entity Type:Organization
Organization Name:CHEMICAL DEPENDENT EDUCATION PROGRAMS
Other - Org Name:RECOVERY HEALTHCARE CORPORATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKAL
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MS MAC CCJS
Authorized Official - Phone:214-350-1711
Mailing Address - Street 1:2520 ELECTRONIC LN
Mailing Address - Street 2:SUITE 810
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75220-1252
Mailing Address - Country:US
Mailing Address - Phone:214-350-1711
Mailing Address - Fax:214-350-4661
Practice Address - Street 1:2520 ELECTRONIC LN
Practice Address - Street 2:SUITE 810
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75220-1252
Practice Address - Country:US
Practice Address - Phone:214-350-1711
Practice Address - Fax:214-350-4661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1761-A261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health