# STREET SMART RECOVERY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** STREET SMART RECOVERY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518509579
- **Authorized official:** MR. JEFF RAYBON (MEMBER MANAGER)
- **Authorized official phone:** (225) 439-7255

## Contact information

- **Practice address:** 11606 SOUTHFORK AVE, BATON ROUGE, LA 70816-5235
- **Practice address phone:** (225) 439-7255
- **Mailing address:** 12602 COURSEY BLVD, BATON ROUGE, LA 70816-4555
- **Mailing address phone:** (225) 439-7255

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |

## Other

- **Enumeration date:** 10/11/2019
- **Last updated:** 10/11/2019