Corydon Recovery LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

CORYDON RECOVERY LLC

Doing business as

Hickory Treatment Center at Corydon

Practice address

315 Country Club Rd
Corydon, IN 47112-1751

Phone

(812) 738-2190

NPI assigned

Oct 10, 2019

Last updated

Apr 16, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Howard Bromberg

Title

Coo

Phone

(317) 784-4402

Specialties & licenses 1

Addresses

Other names 1

• Hickory Treatment Center at Corydon Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1396387478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191310",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631197310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 COUNTRY CLUB RD",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471121751",
            "telephone_number": "812-738-2190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORYDON RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-10",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "BROMBERG",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "317-784-4402"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hickory Treatment Center at Corydon",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hickory Treatment Center at Corydon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in Corydon, IN
• Providers in Corydon, IN by specialty
• Substance Abuse Rehabilitation Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.