Healthcare Provider Details

I. General information

NPI: 1407923501
Provider Name (Legal Business Name): RECOVERY CONSULTANTS INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 05/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 12 MILE RD
BERKLEY MI
48072
US

IV. Provider business mailing address

2710 12 MILE RD
BERKLEY MI
48072-1630
US

V. Phone/Fax

Practice location:
  • Phone: 248-543-1090
  • Fax: 248-543-0017
Mailing address:
  • Phone: 248-543-1090
  • Fax: 248-543-0017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberSA0631165
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number631165
License Number StateMI

VIII. Authorized Official

Name: MS. KATHY LYNN SMALLER
Title or Position: CEO
Credential:
Phone: 248-543-1090