Provider Demographics
NPI:1962674762
Name:RECOVERCARE, LLC
Entity Type:Organization
Organization Name:RECOVERCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT /CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:S
Authorized Official - Last Name:ZAPPONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-489-9449
Mailing Address - Street 1:1920 STANLEY GAULT PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4209
Mailing Address - Country:US
Mailing Address - Phone:502-489-9449
Mailing Address - Fax:502-657-3126
Practice Address - Street 1:4360 PINELL ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95838-2928
Practice Address - Country:US
Practice Address - Phone:916-646-2031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10071367600002332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200369260Medicaid
AZ645697Medicaid
1148010006Medicare NSC
1148010001Medicare NSC
1148010002Medicare NSC
IN200369260Medicaid
1148010005Medicare NSC