Healthcare Provider Details

I. General information

NPI: 1053997536
Provider Name (Legal Business Name): RECOVERY INNOVATIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11361 N 99TH AVE STE 100
PEORIA AZ
85345-5470
US

IV. Provider business mailing address

2701 N 16TH ST STE 316
PHOENIX AZ
85006-1266
US

V. Phone/Fax

Practice location:
  • Phone: 602-650-1212
  • Fax:
Mailing address:
  • Phone: 602-650-1212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: PAMELA D SAULPAW
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 602-898-7254