Provider Demographics
NPI:1871250613
Name:UNITY RECOVERY LLC
Entity Type:Organization
Organization Name:UNITY RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:PAULSON
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:507-317-8040
Mailing Address - Street 1:20995 241ST AVE
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:56334-4564
Mailing Address - Country:US
Mailing Address - Phone:507-317-8040
Mailing Address - Fax:
Practice Address - Street 1:20995 241ST AVE
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:MN
Practice Address - Zip Code:56334-4564
Practice Address - Country:US
Practice Address - Phone:507-317-8040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder