Healthcare Provider Details

I. General information

NPI: 1013642610
Provider Name (Legal Business Name): RECOVER PEACE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 07/19/2022
Certification Date: 07/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 COLLEGE AVE SE
GRAND RAPIDS MI
49503-5921
US

IV. Provider business mailing address

6891 PINE BLUFF CT SW
BYRON CENTER MI
49315-8370
US

V. Phone/Fax

Practice location:
  • Phone: 616-773-9361
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY RIJFKOGEL
Title or Position: MANAGER
Credential: LPC
Phone: 616-773-9361