Provider Demographics
NPI:1073863783
Name:RESIDENTIAL RECOVERY SERVICES
Entity Type:Organization
Organization Name:RESIDENTIAL RECOVERY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:C
Authorized Official - Last Name:CALLENDER
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:724-745-7535
Mailing Address - Street 1:201 S JOHNSON RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:PA
Mailing Address - Zip Code:15342-1351
Mailing Address - Country:US
Mailing Address - Phone:724-745-7535
Mailing Address - Fax:724-745-3383
Practice Address - Street 1:201 S JOHNSON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:PA
Practice Address - Zip Code:15342-1351
Practice Address - Country:US
Practice Address - Phone:724-745-7535
Practice Address - Fax:724-745-3383
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AADVANTAGE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health