Provider Demographics
NPI:1497376792
Name:BIGIVV
Entity Type:Organization
Organization Name:BIGIVV
Other - Org Name:RECOVERY CONNECT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GIOVANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VILOMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-574-4297
Mailing Address - Street 1:824 HICKMAN RD APT D32
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-7108
Mailing Address - Country:US
Mailing Address - Phone:912-574-4297
Mailing Address - Fax:
Practice Address - Street 1:824 HICKMAN RD APT D32
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-7108
Practice Address - Country:US
Practice Address - Phone:912-574-4297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-28
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health