Provider Demographics
NPI:1114070307
Name:RECOVERY REVOLUTION, INC.
Entity Type:Organization
Organization Name:RECOVERY REVOLUTION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CAADC, LPC, NCC
Authorized Official - Phone:610-599-7700
Mailing Address - Street 1:PO BOX 746
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:PA
Mailing Address - Zip Code:18013-0746
Mailing Address - Country:US
Mailing Address - Phone:610-599-7700
Mailing Address - Fax:610-599-7714
Practice Address - Street 1:109 BROADWAY
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:PA
Practice Address - Zip Code:18013-2505
Practice Address - Country:US
Practice Address - Phone:610-599-7700
Practice Address - Fax:610-599-7714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA487033251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable