Provider Demographics
NPI:1285017798
Name:RECOVERY HOME CARE LLC
Entity Type:Organization
Organization Name:RECOVERY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOB
Authorized Official - Middle Name:
Authorized Official - Last Name:GICHURU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-427-4005
Mailing Address - Street 1:130 PARKER ST
Mailing Address - Street 2:SUITE 12
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1556
Mailing Address - Country:US
Mailing Address - Phone:978-427-4005
Mailing Address - Fax:
Practice Address - Street 1:130 PARKER ST
Practice Address - Street 2:SUITE 12
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1556
Practice Address - Country:US
Practice Address - Phone:978-427-4005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-01
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health