Provider Demographics
NPI:1346991643
Name:RECOVERY FROM SOCIETY INC
Entity Type:Organization
Organization Name:RECOVERY FROM SOCIETY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:APRN
Authorized Official - Phone:813-497-0497
Mailing Address - Street 1:455 N US HIGHWAY 41 UNIT 1126
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33575-5246
Mailing Address - Country:US
Mailing Address - Phone:813-497-0497
Mailing Address - Fax:949-863-5134
Practice Address - Street 1:312 SHELL MANOR DR
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33570-5005
Practice Address - Country:US
Practice Address - Phone:813-497-0497
Practice Address - Fax:949-863-5134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-18
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty