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General NPI Number Information
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NPI Number | 1992516009
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Entity Type | Organization
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Legal Business Name | RECOVERY TELECARE LLC
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 724 BIELENBERG DR
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City | WOODBURY
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State | MN
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Zip | 55125-2620
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Country | US
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Telephone | 651-270-7870
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Fax |
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Provider Business Mailing Address
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Address Line | 724 BIELENBERG DR
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City | WOODBURY
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State | MN
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Zip | 55125-2620
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Country | US
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Telephone | 651-270-7870
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MELISSA M. J. BAUMGART
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Credential | FNP, APRN-BC
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Telephone | 651-270-7870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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