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General NPI Number Information
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NPI Number | 1669819280
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Entity Type | Organization
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Legal Business Name | RECOVER HEALTH RESOURCES LLC
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Dates
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Enumeration Date | 05/23/2013
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Last Update Date | 05/31/2013
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Provider Practice Location Address
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Address Line | 3800 AMERICAN BLVD W SUITE 1500
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City | BLOOMINGTON
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State | MN
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Zip | 55431-4420
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Country | US
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Telephone | 612-844-9050
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Fax |
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Provider Business Mailing Address
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Address Line | 3800 AMERICAN BLVD W SUITE 1500
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City | BLOOMINGTON
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State | MN
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Zip | 55431-4420
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Country | US
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Telephone | 612-844-9050
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FAYSAL ABDIAZIZ AHMED
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Credential |
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Telephone | 763-913-8054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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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 | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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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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