Provider Demographics
NPI:1427360734
Name:RECOVERY INNOVATIONS INC
Entity Type:Organization
Organization Name:RECOVERY INNOVATIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DIRECTOR, CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:CORINA
Authorized Official - Middle Name:
Authorized Official - Last Name:OGAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-636-3085
Mailing Address - Street 1:2601 N 16TH ST STE 316
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-1404
Mailing Address - Country:US
Mailing Address - Phone:602-650-1212
Mailing Address - Fax:602-636-5211
Practice Address - Street 1:822 S 333RD ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6343
Practice Address - Country:US
Practice Address - Phone:602-650-1212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RECOVERY INNOVATIONS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-02
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No251S00000XAgenciesCommunity/Behavioral Health