Organization
VIA DOLOROSA RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN HOFFMAN (ADMINISTRATOR)
(614) 313-2440
Entity
Organization
Contact information
Practice address
55 RODEO DR, MOREHEAD, KY 40351-7470
(606) 784-1142
(606) 780-0213
Mailing address
55 RODEO DR, MOREHEAD, KY 40351-7470
(606) 784-1142
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/09/2024
Last updated
05/05/2025
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