Provider Demographics
NPI:1861750945
Name:OAKWOOD RECOVERY PLACE
Entity type:Organization
Organization Name:OAKWOOD RECOVERY PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:BEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:CSAC
Authorized Official - Phone:828-855-9595
Mailing Address - Street 1:PO BOX 2352
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28603-2352
Mailing Address - Country:US
Mailing Address - Phone:828-855-9595
Mailing Address - Fax:828-855-9599
Practice Address - Street 1:323 2ND ST NW
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-4904
Practice Address - Country:US
Practice Address - Phone:828-855-9595
Practice Address - Fax:828-855-9599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC018-093261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder