Provider Demographics
NPI:1619268786
Name:RECOVERY RESOURCES
Entity Type:Organization
Organization Name:RECOVERY RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT: & CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:A
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-431-4131
Mailing Address - Street 1:3950 CHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-4625
Mailing Address - Country:US
Mailing Address - Phone:216-431-4131
Mailing Address - Fax:216-431-4151
Practice Address - Street 1:13944 EUCLID AVE
Practice Address - Street 2:HURON COMMUNITY HEALTH CENTER
Practice Address - City:EAST CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-3832
Practice Address - Country:US
Practice Address - Phone:216-767-4283
Practice Address - Fax:216-431-4151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH493564251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0721240Medicaid
OHRE9370211Medicare PIN