| Port45 Recovery Llc | |
|
1907 11th St Portsmouth OH 45662-4531 | |
| (740) 529-7356 | |
| Not Available |
| Full Name | Port45 Recovery Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1907 11th St, Portsmouth, Ohio |
| Authorized Official Name and Position | Bryan Mcbride (FINANCIAL EXECUTIVE) |
| Authorized Official Contact | 6145914710 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Port45 Recovery Llc 921 Eastwind Dr Ste 101 Westerville OH 43081-5302 Ph: (614) 591-4710 | Port45 Recovery Llc 1907 11th St Portsmouth OH 45662-4531 Ph: (740) 529-7356 |
| NPI Number | 1053944033 |
|---|---|
| Provider Enumeration Date | 02/18/2020 |
| Last Update Date | 02/18/2020 |
| Certification Date | 02/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053944033 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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