Healthcare Provider Details
I. General information
NPI: 1174460505
Provider Name (Legal Business Name): I SHALL RECOVER IT ALL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6410 S 58TH AVE
LAVEEN AZ
85339-2262
US
IV. Provider business mailing address
6410 S 58TH AVE
LAVEEN AZ
85339-2262
US
V. Phone/Fax
- Phone: 602-551-0659
- Fax:
- Phone: 602-551-0659
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 320600000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Residential Treatment Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 276400000X |
| Taxonomy | Substance Use Disorder Rehabilitation Hospital Unit |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JANICE
LOUISE
JACKSON
Title or Position: CEO
Credential:
Phone: 602-551-0659