Provider Demographics
NPI:1275927840
Name:ALLIANCE RECOVERY SPECIALISTS LLC
Entity Type:Organization
Organization Name:ALLIANCE RECOVERY SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-536-7461
Mailing Address - Street 1:2371 W STATE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-3594
Mailing Address - Country:US
Mailing Address - Phone:330-536-7461
Mailing Address - Fax:
Practice Address - Street 1:2371 W STATE ST
Practice Address - Street 2:SUITE A
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-3594
Practice Address - Country:US
Practice Address - Phone:330-536-7461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-23
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty