Provider Demographics
NPI:1841874237
Name:ROOTED IN RECOVERY THERAPEUTIC SERVICES LLC
Entity type:Organization
Organization Name:ROOTED IN RECOVERY THERAPEUTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AL
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-915-4211
Mailing Address - Street 1:PO BOX 50451
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23250-0451
Mailing Address - Country:US
Mailing Address - Phone:804-833-0467
Mailing Address - Fax:
Practice Address - Street 1:5 N BATTERY ST
Practice Address - Street 2:
Practice Address - City:HIGHLAND SPRINGS
Practice Address - State:VA
Practice Address - Zip Code:23075-1107
Practice Address - Country:US
Practice Address - Phone:804-833-0467
Practice Address - Fax:804-616-4845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-11
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health