Basic Information
| Provider Information | |||||||||
| NPI: | 1730458738 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RECOVERY HEALTH SERVICES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2801 CHEVERLY AVE | ||||||||
| Address2: | |||||||||
| City: | CHEVERLY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207853125 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017725174 | ||||||||
| FaxNumber: | 3017725647 | ||||||||
| Practice Location | |||||||||
| Address1: | 2801 CHEVERLY AVE | ||||||||
| Address2: | |||||||||
| City: | CHEVERLY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207853125 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017725174 | ||||||||
| FaxNumber: | 3017725647 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2011 | ||||||||
| LastUpdateDate: | 12/20/2011 | ||||||||
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| AuthorizedOfficialLastName: | SAWYER | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF CONTRACTS MANAGEMENT | ||||||||
| AuthorizedOfficialTelephone: | 4439040145 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | LCADC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | 22177 | MD | Y | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No ID Information.