Individual
SCOTT RICHARDSON
Active
Individual
SCOTT RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
519169
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
519169
—
OR
Enumeration date
12/29/2017
Last updated
12/29/2017
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