Provider Demographics
NPI:1760821250
Name:VANCE RECOVERY, PC
Entity Type:Organization
Organization Name:VANCE RECOVERY, PC
Other - Org Name:VANCE RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM SPONSOR/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:D
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-676-9699
Mailing Address - Street 1:PO BOX 135
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-0135
Mailing Address - Country:US
Mailing Address - Phone:252-572-2625
Mailing Address - Fax:252-572-2955
Practice Address - Street 1:510 DABNEY DR
Practice Address - Street 2:SUITE B
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-3946
Practice Address - Country:US
Practice Address - Phone:919-676-9699
Practice Address - Fax:919-676-9946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health