| Recovery Resource Group | |
|
900 20th St Huntington WV 25703-1810 | |
| (681) 378-3908 | |
| Not Available |
| Full Name | Recovery Resource Group |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 900 20th St, Huntington, West Virginia |
| Authorized Official Name and Position | Ryan Michael Fields (OWNER/MEMBER) |
| Authorized Official Contact | 3049729447 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Recovery Resource Group 900 20th St Huntington WV 25703-1810 Ph: (681) 378-3908 | Recovery Resource Group 900 20th St Huntington WV 25703-1810 Ph: (681) 378-3908 |
| NPI Number | 1669066858 |
|---|---|
| Provider Enumeration Date | 02/27/2021 |
| Last Update Date | 06/16/2023 |
| Certification Date | 06/16/2023 |
| Medicare PECOS PAC ID | 1355700030 |
|---|---|
| Medicare Enrollment ID | O20230629001187 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669066858 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Kiran Shashi Devaraj |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003878984 PECOS PAC ID: 6204857105 Enrollment ID: I20051207000524 |
| Provider Name | Tabitha Lynn Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073003117 PECOS PAC ID: 0840521811 Enrollment ID: I20191007002095 |
| Provider Name | Patricia Nicole Stillwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700438918 PECOS PAC ID: 2769896158 Enrollment ID: I20240507001794 |
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