MEDICARE: I SHALL RECOVER IT ALL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
2	276400000X	Substance Use Disorder Rehabilitation Hospital Unit

General Provider Information

NPI Number	:	1174460505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	I SHALL RECOVER IT ALL LLC

Provider Business Mailing Address
First Line	:	6410 S 58TH AVE
Second Line	:
City	:	LAVEEN
State	:	AZ
Zip	:	85339-2262
Country	:	US
Telephone Number	:	602-551-0659
Fax Number	:

Provider Business Practice Location Address
First Line	:	7857 W MIAMI ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85043-1787
Country	:	US
Telephone Number	:	602-551-0659
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JANICE LOUISE JACKSON
Credential	:
Telephone Number	:	602-551-0659

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	06/19/2026

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Directions to “I SHALL RECOVER IT ALL LLC ” Practice Location

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