Provider Demographics
NPI:1619722675
Name:RECOVERY 4 TODAY PLLC
Entity Type:Organization
Organization Name:RECOVERY 4 TODAY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN (KATIE)
Authorized Official - Middle Name:A
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:320-905-6152
Mailing Address - Street 1:1700 TECHNOLOGY DR NE SUITE 203 #2
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-2295
Mailing Address - Country:US
Mailing Address - Phone:320-905-6152
Mailing Address - Fax:320-262-8393
Practice Address - Street 1:1700 TECHNOLOGY DR NE SUITE 203 #2
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-2295
Practice Address - Country:US
Practice Address - Phone:320-905-6152
Practice Address - Fax:320-262-8393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility