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General NPI Number Information
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NPI Number | 1003787193
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Entity Type | Organization
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Legal Business Name | RECOVERY INN, LLC
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Dates
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Enumeration Date | 09/13/2025
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 2338 AMHERST ST
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City | EAST MEADOW
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State | NY
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Zip | 11554-4025
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Country | US
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Telephone | 646-369-7441
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Fax | 646-369-7441
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Provider Business Mailing Address
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Address Line | 2338 AMHERST ST
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City | EAST MEADOW
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State | NY
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Zip | 11554-4025
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | NANCY E REILLY
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Credential |
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Telephone | 646-369-7442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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