Provider Demographics
NPI:1720303787
Name:HUNTSVILLE RECOVERY, INC.
Entity Type:Organization
Organization Name:HUNTSVILLE RECOVERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:256-721-1940
Mailing Address - Street 1:4040 INDEPENDENCE DR NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35816-3012
Mailing Address - Country:US
Mailing Address - Phone:256-721-1940
Mailing Address - Fax:256-721-1934
Practice Address - Street 1:4040 INDEPENDENCE DR NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35816-3012
Practice Address - Country:US
Practice Address - Phone:256-721-1940
Practice Address - Fax:256-721-1934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-02
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL-10041-M261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone