Healthcare Provider Details

I. General information

NPI: 1003787193
Provider Name (Legal Business Name): RECOVERY INN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2338 AMHERST ST
EAST MEADOW NY
11554-4025
US

IV. Provider business mailing address

2338 AMHERST ST
EAST MEADOW NY
11554-4025
US

V. Phone/Fax

Practice location:
  • Phone: 646-369-7441
  • Fax: 646-369-7441
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NANCY E REILLY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 646-369-7442