Provider Demographics
NPI:1306567342
Name:BETHESDA RECOVERY
Entity type:Organization
Organization Name:BETHESDA RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:HERNDON
Authorized Official - Last Name:SWEAT
Authorized Official - Suffix:
Authorized Official - Credentials:CADCII
Authorized Official - Phone:912-283-8580
Mailing Address - Street 1:1010 MARY ST
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31503-3849
Mailing Address - Country:US
Mailing Address - Phone:912-283-8580
Mailing Address - Fax:
Practice Address - Street 1:1010 MARY ST
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31503-3849
Practice Address - Country:US
Practice Address - Phone:912-283-8580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility