Provider Demographics
NPI:1497427223
Name:RECOVERY CONCEPTS III, LLC
Entity Type:Organization
Organization Name:RECOVERY CONCEPTS III, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:EGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:985-705-3263
Mailing Address - Street 1:8055 WINNERS CIR
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-7509
Mailing Address - Country:US
Mailing Address - Phone:985-705-3263
Mailing Address - Fax:346-616-1087
Practice Address - Street 1:5334 S ARCHER AVE STE A
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60632-4970
Practice Address - Country:US
Practice Address - Phone:985-705-3263
Practice Address - Fax:346-616-1087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone