NPIMap

Organization Active NPI

Golden Triangle Recovery Center, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Starkville, MS
National Provider Identifier
1053528901
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
FS87-DADA-OP-01 Issued in MS
Legal business name
GOLDEN TRIANGLE RECOVERY CENTER, INC.
Practice address
322 University Dr
Starkville, MS 39759-2955
Phone
(662) 324-2230
Fax
(662) 324-2230
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Michael J. Valentine, M.S., CAADC, LCMHT
Title
Executive Director
Phone
(662) 324-2230

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X FS87-DADA-OP-01 MS Primary

Addresses

Primary practice location

322 University Dr
Starkville, MS 39759-2955

Mailing address

905 Louisville St
Starkville, MS 39759-3920
Phone (662) 324-2230

National Provider Directory

National Provider Directory

Locations

322 University Dr
Starkville, MS 39759
Phone (662) 324-2230

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374537600000",
    "number": "1053528901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 LOUISVILLE ST",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397593920",
            "telephone_number": "662-324-2230",
            "fax_number": "662-324-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 UNIVERSITY DR",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397592955",
            "telephone_number": "662-324-2230",
            "fax_number": "662-324-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN TRIANGLE RECOVERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2013-07-23",
        "status": "A",
        "authorized_official_last_name": "VALENTINE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "662-324-2230",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S., CAADC, LCMHT"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MS",
            "license": "FS87-DADA-OP-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Starkville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.