Provider Demographics
NPI:1457802274
Name:RINCON RECOVERY, LLC
Entity type:Organization
Organization Name:RINCON RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-401-9529
Mailing Address - Street 1:5956 E PIMA ST
Mailing Address - Street 2:STE 140
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-4375
Mailing Address - Country:US
Mailing Address - Phone:520-272-0609
Mailing Address - Fax:
Practice Address - Street 1:5956 E PIMA ST
Practice Address - Street 2:STE 140
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4375
Practice Address - Country:US
Practice Address - Phone:520-272-0609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC7857261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder