Provider Demographics
NPI:1790402311
Name:F.R.O.G. RECOVERY INC. (FINDING RECOVERY OPTIONS FOR GROWTH)
Entity Type:Organization
Organization Name:F.R.O.G. RECOVERY INC. (FINDING RECOVERY OPTIONS FOR GROWTH)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-617-9948
Mailing Address - Street 1:332 W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46016-1330
Mailing Address - Country:US
Mailing Address - Phone:765-617-9948
Mailing Address - Fax:
Practice Address - Street 1:332 W 11TH ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46016-1330
Practice Address - Country:US
Practice Address - Phone:765-617-9948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health