Organization
SOUTHERN OHIO PREMIER RECOVERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FAITH ANN BIVENS (OWNER)
(740) 981-6987
Entity
Organization
Contact information
Practice address
6431 STATE ROUTE 104, MCDERMOTT, OH 45652-8943
(740) 981-6987
Mailing address
6587 STATE ROUTE 104, MC DERMOTT, OH 45652-8943
(740) 981-6987
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
08/04/2021
Last updated
03/05/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up