Provider Demographics
NPI:1760742993
Name:PIKE COUNTY RECOVERY COUNCIL INC
Entity Type:Organization
Organization Name:PIKE COUNTY RECOVERY COUNCIL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:CDCA
Authorized Official - Phone:740-947-6727
Mailing Address - Street 1:PO BOX 226
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:OH
Mailing Address - Zip Code:45690-0226
Mailing Address - Country:US
Mailing Address - Phone:740-947-6727
Mailing Address - Fax:740-947-6917
Practice Address - Street 1:217 E EMMITT AVE
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:OH
Practice Address - Zip Code:45690-1337
Practice Address - Country:US
Practice Address - Phone:740-947-6727
Practice Address - Fax:740-947-6917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)