Provider Demographics
NPI:1093949943
Name:COMPLETE RECOVERY, LLC
Entity Type:Organization
Organization Name:COMPLETE RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BURDETTA
Authorized Official - Middle Name:F
Authorized Official - Last Name:ALLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-444-2098
Mailing Address - Street 1:2460 N 48TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-2803
Mailing Address - Country:US
Mailing Address - Phone:414-444-2098
Mailing Address - Fax:414-444-2098
Practice Address - Street 1:2460 N 48TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53210-2803
Practice Address - Country:US
Practice Address - Phone:414-444-2098
Practice Address - Fax:414-444-2098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WICO63445332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment