Provider Demographics
NPI:1619850823
Name:RED THREAD RECOVERY
Entity type:Organization
Organization Name:RED THREAD RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:DEGLER
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:317-214-2167
Mailing Address - Street 1:2775 ORCHARD RUN RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45449-2831
Mailing Address - Country:US
Mailing Address - Phone:317-214-2167
Mailing Address - Fax:
Practice Address - Street 1:2775 ORCHARD RUN RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45449-2831
Practice Address - Country:US
Practice Address - Phone:317-214-2167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health