Provider Demographics
NPI:1548791494
Name:THE RECOVERY RESEARCH NETWORK
Entity Type:Organization
Organization Name:THE RECOVERY RESEARCH NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:GENA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-812-2000
Mailing Address - Street 1:110 JFK DR
Mailing Address - Street 2:BLD B, UNIT 5, SUITE. 118
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-1146
Mailing Address - Country:US
Mailing Address - Phone:561-812-2000
Mailing Address - Fax:
Practice Address - Street 1:110 JFK DR
Practice Address - Street 2:BLD B, UNIT 5, SUITE. 118
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462
Practice Address - Country:US
Practice Address - Phone:561-812-2000
Practice Address - Fax:561-423-0822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL50012084A0401X
FL10093092084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty