Healthcare Provider Details

I. General information

NPI: 1770292880
Provider Name (Legal Business Name): ACTUAL RECOVERY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2022
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 EASTON RD
WILLOW GROVE PA
19090-2528
US

IV. Provider business mailing address

608 EASTON RD
WILLOW GROVE PA
19090-2528
US

V. Phone/Fax

Practice location:
  • Phone: 445-246-1237
  • Fax:
Mailing address:
  • Phone: 445-246-1237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DIANA LENGEL
Title or Position: MEMBER
Credential:
Phone: 445-246-1237