Basic Information
| Provider Information | |||||||||
| NPI: | 1437554359 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RECOVERY INNOVATIONS, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2701 N 16TH STREET | ||||||||
| Address2: | SUITE 316 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6026501212 | ||||||||
| FaxNumber: | 6026365283 | ||||||||
| Practice Location | |||||||||
| Address1: | 2150 FREEMAN RD E STE 1 | ||||||||
| Address2: | |||||||||
| City: | FIFE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984243776 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535842300 | ||||||||
| FaxNumber: | 2539227611 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2014 | ||||||||
| LastUpdateDate: | 06/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | OGAZ | ||||||||
| AuthorizedOfficialFirstName: | CORINA | ||||||||
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| AuthorizedOfficialTitleorPosition: | ASSOCIATE DIRECTOR, CREDENTIALING | ||||||||
| AuthorizedOfficialTelephone: | 6026363085 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 06/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 323P00000X | Y | Residential Treatment Facilities | Psychiatric Residential Treatment Facility |
No ID Information.