Provider Demographics
NPI:1740861061
Name:BEATY RECOVERY SERVICES LLC
Entity type:Organization
Organization Name:BEATY RECOVERY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:BEATY
Authorized Official - Last Name:CLONINGER
Authorized Official - Suffix:
Authorized Official - Credentials:LCAS, CCS, SAP
Authorized Official - Phone:704-864-3900
Mailing Address - Street 1:436 E LONG AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2543
Mailing Address - Country:US
Mailing Address - Phone:170-486-4390
Mailing Address - Fax:704-419-2135
Practice Address - Street 1:320 E GRAHAM ST STE 3
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-5569
Practice Address - Country:US
Practice Address - Phone:704-419-2130
Practice Address - Fax:704-419-2135
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEATY RECOVERY SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty