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General NPI Number Information
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NPI Number | 1851057426
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Entity Type | Organization
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Legal Business Name | TRIPLE R RECOVERY, LLC
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Dates
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Enumeration Date | 11/09/2021
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 9125 GRANT ROAD
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City | WHITE MOUNTAIN LAKES ESTATES
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State | AZ
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Zip | 85912
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Country | US
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Telephone | 480-266-5149
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 E WHIPPLE
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City | SHOW LOW
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State | AZ
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Zip | 85901-6622
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Country | US
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Telephone | 480-266-5149
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | RHONDA L ELLSWORTH
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Credential |
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Telephone | 480-266-5149
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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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