Provider Demographics
NPI:1295581106
Name:RECOVER VIRGINIA
Entity type:Organization
Organization Name:RECOVER VIRGINIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:LINCOLN
Authorized Official - Last Name:STANCIL
Authorized Official - Suffix:
Authorized Official - Credentials:RPRS
Authorized Official - Phone:540-958-2672
Mailing Address - Street 1:103 MOUNTAINEER DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24426-6302
Mailing Address - Country:US
Mailing Address - Phone:540-958-2672
Mailing Address - Fax:
Practice Address - Street 1:451 W PARK ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:VA
Practice Address - Zip Code:24426-2722
Practice Address - Country:US
Practice Address - Phone:540-597-3488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-30
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty