| Organization Name: | GOLDEN TRIANGLE RECOVERY CENTER, INC. |
| NPI Number: | 1053528901 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL J. VALENTINE (EXECUTIVE DIRECTOR) |
| Mailing Address: | 322 University Dr Starkville |
| State: | MS US |
| Postal Code: | 397592955 |
| Phone Number: | 6623242230 |
| Fax Number: | 6623242230 |
| NPI Enumeration Date: | 05/17/2007 |
| NPI Last Update Date: | 07/23/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | FS87-DADA-OP-01 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |