Provider Demographics
NPI:1154130581
Name:ROADTRIP 2 RECOVERY, PLLC.
Entity type:Organization
Organization Name:ROADTRIP 2 RECOVERY, PLLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:980-372-2709
Mailing Address - Street 1:6414 W WILKINSON BLVD STE 1031
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-2858
Mailing Address - Country:US
Mailing Address - Phone:980-372-2709
Mailing Address - Fax:980-495-8932
Practice Address - Street 1:204 PRINCE STREET
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012
Practice Address - Country:US
Practice Address - Phone:980-372-2709
Practice Address - Fax:980-495-8932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-31
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty