Provider Demographics
NPI:1952151060
Name:DRUG AND ALCOHOL RECOVERY TREATMENT
Entity Type:Organization
Organization Name:DRUG AND ALCOHOL RECOVERY TREATMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-886-9989
Mailing Address - Street 1:PO BOX 92
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-0092
Mailing Address - Country:US
Mailing Address - Phone:606-886-9989
Mailing Address - Fax:
Practice Address - Street 1:193 E COURT ST
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-1241
Practice Address - Country:US
Practice Address - Phone:606-886-9989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder