Provider Demographics
NPI:1780277368
Name:RECOVERY HEALTH PROFESSIONAL LLC
Entity type:Organization
Organization Name:RECOVERY HEALTH PROFESSIONAL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EMA
Authorized Official - Middle Name:
Authorized Official - Last Name:UKO-ABASI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-824-4070
Mailing Address - Street 1:24 GRASSY MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095-1446
Mailing Address - Country:US
Mailing Address - Phone:413-824-4070
Mailing Address - Fax:
Practice Address - Street 1:171 DWIGHT RD STE 102
Practice Address - Street 2:
Practice Address - City:LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01106-1768
Practice Address - Country:US
Practice Address - Phone:413-824-4070
Practice Address - Fax:413-216-3304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-16
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care