Provider Demographics
NPI:1609305531
Name:SPECIALIZED PERSONAL RECOVERY SERVICES LLC.
Entity Type:Organization
Organization Name:SPECIALIZED PERSONAL RECOVERY SERVICES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-350-0501
Mailing Address - Street 1:1364 ALEXANDER DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49696-9340
Mailing Address - Country:US
Mailing Address - Phone:231-350-0501
Mailing Address - Fax:
Practice Address - Street 1:1364 ALEXANDER DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49696-9340
Practice Address - Country:US
Practice Address - Phone:231-350-0501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services