Organization
124 RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC JOCKERS (OWNER)
(502) 352-4904
Entity
Organization
Contact information
Practice address
200 W BROADWAY ST, FRANKFORT, KY 40601-1933
(502) 352-4904
Mailing address
200 W BROADWAY ST, FRANKFORT, KY 40601-1933
(502) 352-4904
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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