Provider Demographics
NPI:1457666927
Name:RECOVERY SERVICES COUNCIL INC.
Entity Type:Organization
Organization Name:RECOVERY SERVICES COUNCIL INC.
Other - Org Name:RECOVERY SERVICES COUNCIL INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BOB
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:I
Authorized Official - Credentials:AAPS
Authorized Official - Phone:316-651-5716
Mailing Address - Street 1:1611 SOUTH RUTAN
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218
Mailing Address - Country:US
Mailing Address - Phone:316-651-5716
Mailing Address - Fax:316-651-5749
Practice Address - Street 1:1611 SOUTH RUTAN
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218
Practice Address - Country:US
Practice Address - Phone:316-651-5716
Practice Address - Fax:316-651-5749
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RECOVERY SERVICES COUNCIL INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSAPLLIED FOR305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service