Provider Demographics
NPI:1932661972
Name:VISION QUEST RECOVERY LLC
Entity Type:Organization
Organization Name:VISION QUEST RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:KROLL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:248-421-8143
Mailing Address - Street 1:32890 KILLEWALD ST
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-3308
Mailing Address - Country:US
Mailing Address - Phone:248-421-8143
Mailing Address - Fax:586-719-1449
Practice Address - Street 1:32890 KILLEWALD ST
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-3308
Practice Address - Country:US
Practice Address - Phone:248-421-8143
Practice Address - Fax:586-719-1449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes405300000XOther Service ProvidersPrevention ProfessionalGroup - Single Specialty