Provider Demographics
NPI:1700500998
Name:RECOVER HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:RECOVER HEALTHCARE SERVICES LLC
Other - Org Name:RECOVER HEALTHCARE SERVICES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAIWO
Authorized Official - Middle Name:OLAFUNMI
Authorized Official - Last Name:ADEYEMO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:240-646-2414
Mailing Address - Street 1:11571 LAURELWALK DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-3001
Mailing Address - Country:US
Mailing Address - Phone:240-646-2414
Mailing Address - Fax:
Practice Address - Street 1:11571 LAURELWALK DR
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-3001
Practice Address - Country:US
Practice Address - Phone:240-646-2414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-30
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty