| Lawrence County Recovery, Llc | |
|
2903 S 5th St Ironton OH 45638-2866 | |
| (740) 646-6640 | |
| Not Available |
| Full Name | Lawrence County Recovery, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2903 S 5th St, Ironton, Ohio |
| Authorized Official Name and Position | Amanda Brumfield (AST. ADM./BILLING) |
| Authorized Official Contact | 7406466640 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lawrence County Recovery, Llc 2903 S 5th St Ironton OH 45638-2866 Ph: (740) 646-6640 | Lawrence County Recovery, Llc 2903 S 5th St Ironton OH 45638-2866 Ph: (740) 646-6640 |
| NPI Number | 1982266656 |
|---|---|
| Provider Enumeration Date | 07/02/2019 |
| Last Update Date | 01/04/2024 |
| Certification Date | 01/04/2024 |
| Medicare PECOS PAC ID | 8022474030 |
|---|---|
| Medicare Enrollment ID | O20230517002542 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982266656 | NPI | - | NPPES |
| 0359608 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Lesley Jordan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316479967 PECOS PAC ID: 5092077305 Enrollment ID: I20180327001184 |
| Provider Name | Lisa Childress |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770983785 PECOS PAC ID: 9638390107 Enrollment ID: I20190724003649 |
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