Provider Demographics
NPI:1437554359
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 1:2701 N 16TH STREET
Mailing Address - Street 2:SUITE 316
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006
Mailing Address - Country:US
Mailing Address - Phone:602-650-1212
Mailing Address - Fax:602-636-5283
Practice Address - Street 1:2150 FREEMAN RD E STE 1
Practice Address - Street 2:
Practice Address - City:FIFE
Practice Address - State:WA
Practice Address - Zip Code:98424-3776
Practice Address - Country:US
Practice Address - Phone:253-584-2300
Practice Address - Fax:253-922-7611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)