Organization
ANTIDOTE RECOVERY LLC
Active
Other names
R. Miguel Magallanez LCSW, Antidote Recovery
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTO MIGUEL MAGALLANEZ LCSW (CEO)
(812) 624-1180
Entity
Organization
Contact information
Practice address
3310 E 10TH ST # 4-156, JEFFERSONVILLE, IN 47130-7285
(812) 624-1180
Mailing address
3310 E 10TH ST # 4-156, JEFFERSONVILLE, IN 47130-7285
(812) 624-1180
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
09/15/2021
Last updated
09/15/2021
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