Provider Demographics
NPI:1831826320
Name:ROCK CREEK RECOVERY LLC
Entity type:Organization
Organization Name:ROCK CREEK RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SPAUR
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:949-226-4633
Mailing Address - Street 1:449 COON CRK
Mailing Address - Street 2:
Mailing Address - City:CULLODEN
Mailing Address - State:WV
Mailing Address - Zip Code:25510-8010
Mailing Address - Country:US
Mailing Address - Phone:949-226-4633
Mailing Address - Fax:
Practice Address - Street 1:449 COON CRK
Practice Address - Street 2:
Practice Address - City:CULLODEN
Practice Address - State:WV
Practice Address - Zip Code:25510-8010
Practice Address - Country:US
Practice Address - Phone:949-226-4633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility