Provider Demographics
NPI:1750676714
Name:ROAD TO RECOVERY, LLC
Entity Type:Organization
Organization Name:ROAD TO RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-813-7297
Mailing Address - Street 1:PO BOX 585
Mailing Address - Street 2:
Mailing Address - City:SPRING HOPE
Mailing Address - State:NC
Mailing Address - Zip Code:27882-0585
Mailing Address - Country:US
Mailing Address - Phone:252-813-7297
Mailing Address - Fax:
Practice Address - Street 1:1308 W WILSON ST
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-4824
Practice Address - Country:US
Practice Address - Phone:252-813-7297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health