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General NPI Number Information
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NPI Number | 1093387615
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Entity Type | Organization
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Legal Business Name | RECOVER 12 SOLUTIONS, LLC
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Dates
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Enumeration Date | 07/13/2021
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 70 FULLER ST
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City | NEW LONDON
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State | CT
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Zip | 06320-2728
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Country | US
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Telephone | 860-389-4327
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Fax | 860-574-9676
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Provider Business Mailing Address
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Address Line | 70 FULLER ST
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City | NEW LONDON
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State | CT
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Zip | 06320-2728
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Country | US
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Telephone | 860-389-4327
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Fax | 860-574-9676
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Authorized Official
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Title or Position | MEMBER
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Name | CARRIE ARTEAGA
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Credential |
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Telephone | 860-389-4327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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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 | 177F00000X
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Taxonomy Name | Lodging Provider
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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