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General NPI Number Information
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NPI Number | 1942880232
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Entity Type | Organization
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Legal Business Name | RECOVER COLLABORATIVE
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Dates
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Enumeration Date | 04/11/2021
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Last Update Date | 04/11/2021
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Provider Practice Location Address
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Address Line | 23 KERRY PARK
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City | PITTSFORD
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State | NY
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Zip | 14534-2613
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Country | US
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Telephone | 585-698-8694
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Fax |
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Provider Business Mailing Address
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Address Line | 23 KERRY PARK
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City | PITTSFORD
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State | NY
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Zip | 14534-2613
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Country | US
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Telephone | 585-698-8694
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF BILLING AND FINANCE
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Name | ERIC GRILLS
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Credential |
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Telephone | 585-698-8694
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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 | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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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 | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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License Number |
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License Number State |
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