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Organization
PORT45 RECOVERY LLC
Active
Organization
PORT45 RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN MCBRIDE (FINANCIAL EXECUTIVE)
(614) 591-4710
Entity
Organization
Contact information
Practice address
1907 11TH ST, PORTSMOUTH, OH 45662-4531
(740) 529-7356
Mailing address
921 EASTWIND DR STE 101, WESTERVILLE, OH 43081-5302
(614) 591-4710
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/18/2020
Last updated
02/18/2020
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