Provider Demographics
NPI:1740712678
Name:A1 RECOVERY & TREATMENT LLC
Entity type:Organization
Organization Name:A1 RECOVERY & TREATMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:AS CADC
Authorized Official - Phone:515-381-3001
Mailing Address - Street 1:100 E EUCLID AVE
Mailing Address - Street 2:SUITE 157
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50313-4511
Mailing Address - Country:US
Mailing Address - Phone:515-381-3001
Mailing Address - Fax:
Practice Address - Street 1:100 E EUCLID AVE
Practice Address - Street 2:SUITE 157
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50313-4511
Practice Address - Country:US
Practice Address - Phone:515-381-3001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-30
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1397251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health