Organization
MAVERICK ADDICTION SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICKIE J COX L.A.C. NCAC II... (CEO & ADDICTION COUNSELOR)
(812) 953-1181
Entity
Organization
Contact information
Practice address
35 S STATE ST, SUITE 1, NORTH VERNON, IN 47265-1800
(812) 953-1181
(812) 953-1158
Mailing address
PO BOX 951, 35 S. STATE ST., SUITE 1, NORTH VERNON, IN 47265-0951
(812) 953-1181
(812) 953-1158
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
86000039A
IN
104100000X
Social Worker
—
IN
Other
Enumeration date
10/26/2010
Last updated
10/26/2010
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