NPI 1063988228 · live from the CMS NPI Registry
Center For Recovery And Wellness
Psychiatry & Neurology, Addiction Medicine in Mount Vernon, KY. National Provider Identifier 1063988228, active.
NPI record
| NPI | 1063988228 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Addiction Medicine 2084A0401X |
| Practice location | 50 Lovell Ct Ste B, Mount Vernon, KY 40456 |
| Practice phone | 606-386-1917 |
| Mailing address | Po Box 7096, Stockton, CA 95267 |
| Enumerated | October 15, 2018 |
| Last updated | October 24, 2018 |
| Authorized official | Khursheed Siddiqui, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Anesthesiology, Addiction Medicine | 207LA0401X | — |
| Family Medicine, Addiction Medicine | 207QA0401X | — |
| Internal Medicine, Addiction Medicine | 207RA0401X | — |
| Psychiatry & Neurology, Addiction Medicine primary | 2084A0401X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.