Provider Demographics
NPI:1720431562
Name:ROAD 2 RECOVERY, LLC
Entity Type:Organization
Organization Name:ROAD 2 RECOVERY, LLC
Other - Org Name:ROAD 2 RECOVERY
Other - Org Type:Other Name
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEART-TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:317-503-7827
Mailing Address - Street 1:14026 MEADOW LAKE DRIVE
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-5587
Mailing Address - Country:US
Mailing Address - Phone:317-503-7827
Mailing Address - Fax:
Practice Address - Street 1:14026 MEADOW LAKE DRIVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46038-7703
Practice Address - Country:US
Practice Address - Phone:317-507-3827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-17
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22004014A251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health