# CENTER FOR RECOVERY AND WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427404037
- **Authorized official:** DR. KHURSHEED A SIDDIQUI MD (OWNER)
- **Authorized official phone:** (859) 691-0201

## Contact information

- **Practice address:** 300 W BROADWAY ST, DANVILLE, KY 40422
- **Practice address phone:** (859) 236-0606
- **Practice address fax:** (859) 236-0066
- **Mailing address:** 300 W BROADWAY ST, DANVILLE, KY 40422-1408
- **Mailing address phone:** (859) 236-0606
- **Mailing address fax:** (859) 236-0066

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LA0401X | Addiction Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LA0401X | Addiction Medicine (Anesthesiology) Physician | — | — | Yes |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | — | NULL | — |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | — | — | — |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | — |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | — | NULL | — |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | — | — | — |

## Other

- **Enumeration date:** 05/12/2016
- **Last updated:** 02/27/2020