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General NPI Number Information
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NPI Number | 1437323870
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Entity Type | Organization
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Legal Business Name | RECOVERY NETWORK, INC.
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Dates
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Enumeration Date | 04/16/2008
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Last Update Date | 02/11/2009
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Provider Practice Location Address
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Address Line | 1314 W. NATIONAL AVENUE
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City | MILWAUKEE
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State | WI
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Zip | 53204-2163
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Country | US
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Telephone | 414-727-7985
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Fax | 414-727-8121
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Provider Business Mailing Address
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Address Line | 825 S 14TH ST 1314 WEST NATIONAL AVE.
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City | MILWAUKEE
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State | WI
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Zip | 53204-2163
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Country | US
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Telephone | 414-647-9930
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Fax | 414-647-9931
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Authorized Official
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Title or Position | PRESIDENT-RECOVERY NETWORK, INC.
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Name | MR. JAMES S VALONA II
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Credential |
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Telephone | 414-403-0232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2569
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License Number State | WI
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