Organization
VIDA RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES E JUNKIN MA, LPC/LPCC-S (OWNER/CEO)
(307) 338-0274
Entity
Organization
Contact information
Practice address
10127 MOROCCO ST STE 196, SAN ANTONIO, TX 78216-3943
(830) 216-6563
(330) 595-4025
Mailing address
812 POPLAR ST, JOURDANTON, TX 78026-2940
(830) 399-5010
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/19/2023
Last updated
03/17/2026
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