Provider Demographics
NPI:1376337873
Name:REDEMPTION RECOVERY GROUP LLC
Entity type:Organization
Organization Name:REDEMPTION RECOVERY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REX
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-755-4997
Mailing Address - Street 1:2281 VILLAGE MALL DR UNIT 3
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OH
Mailing Address - Zip Code:44906-1153
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:772-873-9997
Practice Address - Street 1:2281 VILLAGE MALL DR UNIT 3
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OH
Practice Address - Zip Code:44906-1153
Practice Address - Country:US
Practice Address - Phone:772-353-1410
Practice Address - Fax:772-873-9997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health