Recovery Resource Group | |
900 20th St Huntington WV 25703-1810 | |
(681) 378-3908 | |
Not Available |
Full Name | Recovery Resource Group |
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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 |
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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 |
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Provider Enumeration Date | 02/27/2021 |
Last Update Date | 06/16/2023 |
Certification Date | 06/16/2023 |
Medicare PECOS PAC ID | 1355700030 |
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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 |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1003878984 PECOS PAC ID: 6204857105 Enrollment ID: I20051207000524 |
Provider Name | Tabitha Lynn Smith |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073003117 PECOS PAC ID: 0840521811 Enrollment ID: I20191007002095 |
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