Provider Demographics
NPI:1508308180
Name:RECOVERY INNOVATIONS, INC
Entity Type:Organization
Organization Name:RECOVERY INNOVATIONS, INC
Other - Org Name:RI INTERNATIONAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOCIATE DIRECTOR, CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:160-234-2717
Mailing Address - Street 1:2701 N 16TH ST
Mailing Address - Street 2:SUITE 316
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-1263
Mailing Address - Country:US
Mailing Address - Phone:602-650-1212
Mailing Address - Fax:602-650-1616
Practice Address - Street 1:9314 PISCATAWAY RD STE 250
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-3630
Practice Address - Country:US
Practice Address - Phone:240-965-1715
Practice Address - Fax:240-965-1716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-14
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health