| Vida Recovery Llc | |
|
812 Poplar St Jourdanton TX 78026-2940 | |
| (830) 399-5010 | |
| Not Available |
| Full Name | Vida Recovery Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 812 Poplar St, Jourdanton, Texas |
| Authorized Official Name and Position | Shiloh Mcclelland (ADMINISTRATOR) |
| Authorized Official Contact | 3302272291 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vida Recovery Llc 812 Poplar St Jourdanton TX 78026-2940 Ph: (830) 399-5010 | Vida Recovery Llc 812 Poplar St Jourdanton TX 78026-2940 Ph: (830) 399-5010 |
| NPI Number | 1235911611 |
|---|---|
| Provider Enumeration Date | 10/19/2023 |
| Last Update Date | 10/19/2023 |
| Certification Date | 10/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235911611 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |