Provider Demographics
NPI:1164891180
Name:RECOVERY PARTNERS, P.C. AT SPRINGBROOK
Entity Type:Organization
Organization Name:RECOVERY PARTNERS, P.C. AT SPRINGBROOK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEPPALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:651-213-4825
Mailing Address - Street 1:1901 ESTHER ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-9529
Mailing Address - Country:US
Mailing Address - Phone:503-554-4375
Mailing Address - Fax:
Practice Address - Street 1:1901 ESTHER ST
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-9529
Practice Address - Country:US
Practice Address - Phone:503-554-4375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty