1841444890 NPI number — TOWNSEND RECOVERY

Table of content: (NPI 1841444890)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841444890 NPI number — TOWNSEND RECOVERY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWNSEND RECOVERY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TOWNSEND RECOVERY,LLC
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841444890
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
36132 EMERALD COAST PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DESTIN
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32541-5776
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-424-3914
Provider Business Mailing Address Fax Number:
850-424-3931

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2600 JOHNSTON ST
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70503-3269
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-266-5155
Provider Business Practice Location Address Fax Number:
337-266-5157
Provider Enumeration Date:
11/04/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HANDLEY
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
850-424-3914

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  388 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1487852026 . This is a "FACILITY OUTPATIENT NPI" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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