Provider Demographics
NPI:1023534013
Name:I AM RECOVERY LLC
Entity type:Organization
Organization Name:I AM RECOVERY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:MORONI
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:801-407-9998
Mailing Address - Street 1:PO BOX 1061
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-1198
Mailing Address - Country:US
Mailing Address - Phone:801-407-9998
Mailing Address - Fax:
Practice Address - Street 1:121 E STATE ST
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-1625
Practice Address - Country:US
Practice Address - Phone:801-407-9998
Practice Address - Fax:801-797-1223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-21
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6019771-3902106H00000X, 261QR0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty