Provider Demographics
NPI:1720133317
Name:ATLANTIC RECOVERY SERVICES, INC.
Entity Type:Organization
Organization Name:ATLANTIC RECOVERY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, FINANCIAL SERVVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-436-3533
Mailing Address - Street 1:944 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-4228
Mailing Address - Country:US
Mailing Address - Phone:562-436-3533
Mailing Address - Fax:562-436-6379
Practice Address - Street 1:944 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-4228
Practice Address - Country:US
Practice Address - Phone:562-436-3533
Practice Address - Fax:562-436-6379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190229AN251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7029Medicaid
CA7145Medicaid
CA6848Medicaid
CA6861Medicaid
CA7023Medicaid
CA7127Medicaid
CA7025Medicaid
CA6775Medicaid
CA7012Medicaid
CA7091Medicaid
CA7124Medicaid
CA7177Medicaid
CA7125Medicaid
CA7126Medicaid
CA7144Medicaid
CA7022Medicaid
CA7024Medicaid
CA7027Medicaid
CA7028Medicaid
CA7146Medicaid