Provider Demographics
NPI:1134833932
Name:STAGES OF RECOVERY, INC
Entity type:Organization
Organization Name:STAGES OF RECOVERY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-251-3414
Mailing Address - Street 1:4413 71ST ST STE G101
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-2319
Mailing Address - Country:US
Mailing Address - Phone:806-412-4174
Mailing Address - Fax:
Practice Address - Street 1:749 GATEWAY ST.
Practice Address - Street 2:STE E-501
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-1196
Practice Address - Country:US
Practice Address - Phone:325-455-2427
Practice Address - Fax:806-500-2935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care