Healthcare Provider Details

I. General information

NPI: 1811654783
Provider Name (Legal Business Name): JUST RECOVER PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2021
Last Update Date: 11/26/2021
Certification Date: 11/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 N CENTRAL AVE STE 122
PHOENIX AZ
85004-2309
US

IV. Provider business mailing address

3905 N 7TH AVE UNIT 7584
PHOENIX AZ
85011-8026
US

V. Phone/Fax

Practice location:
  • Phone: 623-518-0866
  • Fax:
Mailing address:
  • Phone: 623-518-0866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name: MR. JELANI JONES
Title or Position: CEO
Credential: CPSS
Phone: 623-518-0866