Provider Demographics
NPI:1205560067
Name:PERSONAL RESPONSIBILITY RECOVERY
Entity type:Organization
Organization Name:PERSONAL RESPONSIBILITY RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-589-2661
Mailing Address - Street 1:362 OLD WILDCATTERS RD
Mailing Address - Street 2:
Mailing Address - City:LIBERTY HILL
Mailing Address - State:TX
Mailing Address - Zip Code:78642-4649
Mailing Address - Country:US
Mailing Address - Phone:737-356-3731
Mailing Address - Fax:
Practice Address - Street 1:738 COUNTY ROAD 304
Practice Address - Street 2:
Practice Address - City:BERTRAM
Practice Address - State:TX
Practice Address - Zip Code:78605-3936
Practice Address - Country:US
Practice Address - Phone:737-356-3731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4808OtherSUBSTANCE USE DISORDER TREATMENT