Provider Demographics
NPI:1851057426
Name:TRIPLE R RECOVERY, LLC
Entity Type:Organization
Organization Name:TRIPLE R RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ELLSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-266-5149
Mailing Address - Street 1:1301 E WHIPPLE
Mailing Address - Street 2:
Mailing Address - City:SHOW LOW
Mailing Address - State:AZ
Mailing Address - Zip Code:85901-6622
Mailing Address - Country:US
Mailing Address - Phone:480-266-5149
Mailing Address - Fax:
Practice Address - Street 1:9125 GRANT ROAD
Practice Address - Street 2:
Practice Address - City:WHITE MOUNTAIN LAKES ESTATES
Practice Address - State:AZ
Practice Address - Zip Code:85912
Practice Address - Country:US
Practice Address - Phone:480-266-5149
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation