Provider Demographics
NPI:1205963378
Name:WASHINGTON COUNTY RECOVERY ALTERNATIVES
Entity type:Organization
Organization Name:WASHINGTON COUNTY RECOVERY ALTERNATIVES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:W
Authorized Official - Last Name:STATHERS
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:740-568-0733
Mailing Address - Street 1:200 PUTNAM ST
Mailing Address - Street 2:SUITE 728
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-3005
Mailing Address - Country:US
Mailing Address - Phone:740-568-0733
Mailing Address - Fax:740-376-9736
Practice Address - Street 1:200 PUTNAM ST
Practice Address - Street 2:SUITE 728
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-3005
Practice Address - Country:US
Practice Address - Phone:740-568-0733
Practice Address - Fax:740-376-9736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH10365251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health