Basic Information
| Provider Information | |||||||||
| NPI: | 1740438084 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RECOVERY EMPOWERMENT NETWORK, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 E MITCHELL DR | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850122330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022480368 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3450 N HIGLEY RD | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852159702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4809817735 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2008 | ||||||||
| LastUpdateDate: | 11/18/2010 | ||||||||
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| AuthorizedOfficialLastName: | RIDER | ||||||||
| AuthorizedOfficialFirstName: | ANN | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6022480368 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | MSW, CPRP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | CSA08ADHS0187 | AZ | Y | Agencies | Community/Behavioral Health |
No ID Information.