Healthcare Provider Details

I. General information

NPI: 1578076360
Provider Name (Legal Business Name): RECOVERY SERVICES OF CONNECTICUT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2017
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 BRADLEY RD UNIT 6
MADISON CT
06443-2662
US

IV. Provider business mailing address

71 BRADLEY RD UNIT 6
MADISON CT
06443-2662
US

V. Phone/Fax

Practice location:
  • Phone: 401-741-5109
  • Fax:
Mailing address:
  • Phone: 401-741-5109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DANIEL TUFO
Title or Position: CO-OWNER
Credential:
Phone: 954-397-9123