Provider Demographics
NPI:1265809503
Name:M & M RECOVERY MANAGEMENT
Entity type:Organization
Organization Name:M & M RECOVERY MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:GAY
Authorized Official - Suffix:
Authorized Official - Credentials:LCDC
Authorized Official - Phone:903-363-9063
Mailing Address - Street 1:2010 SYBIL LN STE 130
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-1829
Mailing Address - Country:US
Mailing Address - Phone:903-363-9063
Mailing Address - Fax:903-363-9067
Practice Address - Street 1:2010 SYBIL LN STE 130
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-1829
Practice Address - Country:US
Practice Address - Phone:903-363-9063
Practice Address - Fax:903-363-9067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-21
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12715101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty