Provider Demographics
NPI:1457948507
Name:RECOVERY COMMUNITY CONNECTION INC
Entity type:Organization
Organization Name:RECOVERY COMMUNITY CONNECTION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:CRS, CFRS, CPSS
Authorized Official - Phone:570-560-5214
Mailing Address - Street 1:1784 EAST THIRD STREET
Mailing Address - Street 2:BOX 129
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701
Mailing Address - Country:US
Mailing Address - Phone:272-268-3831
Mailing Address - Fax:
Practice Address - Street 1:120 E 3RD ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-6629
Practice Address - Country:US
Practice Address - Phone:272-268-3831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health