Healthcare Provider Details

I. General information

NPI: 1427762665
Provider Name (Legal Business Name): SOLUTIONS RECOVERY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2023
Last Update Date: 01/13/2023
Certification Date: 01/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 EVANS ST
OSHKOSH WI
54901-4605
US

IV. Provider business mailing address

621 EVANS ST
OSHKOSH WI
54901-4605
US

V. Phone/Fax

Practice location:
  • Phone: 920-233-0888
  • Fax: 920-651-0929
Mailing address:
  • Phone: 920-233-0888
  • Fax: 920-651-0929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: TREVOR C FENRICH
Title or Position: EXECUTIVE DIRECTOR
Credential: EMT-B
Phone: 920-233-0888