Provider Demographics
NPI:1649569617
Name:RECOVERY INNOVATIONS, INC
Entity Type:Organization
Organization Name:RECOVERY INNOVATIONS, INC
Other - Org Name:JACKSONVILLE-RECOVERY RESPONSE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:VP/COO
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HINKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-650-1212
Mailing Address - Street 1:2701 N 16TH ST
Mailing Address - Street 2:SUITE 316
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-1263
Mailing Address - Country:US
Mailing Address - Phone:602-650-1212
Mailing Address - Fax:602-636-5211
Practice Address - Street 1:215 MEMORIAL DR
Practice Address - Street 2:B
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6333
Practice Address - Country:US
Practice Address - Phone:910-353-5118
Practice Address - Fax:910-577-1338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health