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Organization
CENTER FOR RECOVERY AND WELLNESS
Active
Organization
CENTER FOR RECOVERY AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHURSHEED A SIDDIQUI (OWNER)
(859) 236-0606
Entity
Organization
Contact information
Practice address
50 LOVELL CT STE B, MOUNT VERNON, KY 40456-2964
(606) 386-1917
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207LA0401X
Addiction Medicine (Anesthesiology) Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
—
Other
Enumeration date
10/15/2018
Last updated
10/24/2018
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