Basic Information
| Provider Information | |||||||||
| NPI: | 1124668306 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OHIO RECOVERY & COUNSELING CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 126 NORTH MARKET STREET | ||||||||
| Address2: | |||||||||
| City: | WEST UNION | ||||||||
| State: | OH | ||||||||
| PostalCode: | 456931209 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 126 N CROSS ST | ||||||||
| Address2: | |||||||||
| City: | WEST UNION | ||||||||
| State: | OH | ||||||||
| PostalCode: | 456931209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9378927140 | ||||||||
| FaxNumber: | 9378927139 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2020 | ||||||||
| LastUpdateDate: | 01/15/2020 | ||||||||
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| AuthorizedOfficialLastName: | DUTT | ||||||||
| AuthorizedOfficialFirstName: | GURU | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9378927140 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 01/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.