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General NPI Number Information
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NPI Number | 1285595710
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Entity Type | Organization
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Legal Business Name | RECOVERY ACADEMY, LLC
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 764 LINCOLN AVE
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City | SAINT PAUL
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State | MN
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Zip | 55105-3347
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Country | US
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Telephone | 651-728-9069
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Fax | 651-448-2147
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Provider Business Mailing Address
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Address Line | 1295 NORTHLAND DR STE 270
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City | MENDOTA HEIGHTS
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State | MN
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Zip | 55120-1373
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Country | US
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Telephone | 651-728-9069
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Fax | 651-448-2147
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | DR. DAMIR STEVAN UTRZAN
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Credential | PH.D., LMFT
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Telephone | 612-900-7021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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