Provider Demographics
NPI:1942744453
Name:RECOVERY CONCEPTS LLC
Entity Type:Organization
Organization Name:RECOVERY CONCEPTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MANKINEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-512-4539
Mailing Address - Street 1:17100 DIXIE HWY STE D
Mailing Address - Street 2:
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-1485
Mailing Address - Country:US
Mailing Address - Phone:708-335-1155
Mailing Address - Fax:708-335-1171
Practice Address - Street 1:17100 DIXIE HWY
Practice Address - Street 2:SUITE D & E
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-1485
Practice Address - Country:US
Practice Address - Phone:708-335-1155
Practice Address - Fax:708-335-1171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder