Provider Demographics
NPI:1043526452
Name:RECOVERY INNOVATIONS OF CALIFORNIA
Entity Type:Organization
Organization Name:RECOVERY INNOVATIONS OF CALIFORNIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-636-4444
Mailing Address - Street 1:2701 N 16TH ST
Mailing Address - Street 2:SUITE 316
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-1263
Mailing Address - Country:US
Mailing Address - Phone:602-650-1212
Mailing Address - Fax:602-636-5211
Practice Address - Street 1:1211 EMBARCADERO
Practice Address - Street 2:SUITE 300
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-5119
Practice Address - Country:US
Practice Address - Phone:510-535-1409
Practice Address - Fax:510-535-1414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health