MEDICARE: RECOVERY RESOURCES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	493564	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619268786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RECOVERY RESOURCES

Provider Business Mailing Address
First Line	:	3950 CHESTER AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44114-4625
Country	:	US
Telephone Number	:	216-431-4131
Fax Number	:	216-431-4151

Provider Business Practice Location Address
First Line	:	13944 EUCLID AVE
Second Line	:	HURON COMMUNITY HEALTH CENTER
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-3832
Country	:	US
Telephone Number	:	216-767-4283
Fax Number	:	216-431-4151

Authorized Official
Title or Position	:	PRESIDENT: & CEO
Name	:	MRS. DEBORA A. RODRIGUEZ
Credential	:
Telephone Number	:	216-431-4131

Provider Enumeration Date	:	04/25/2011
Last Update Date	:	11/14/2011

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Directions to “RECOVERY RESOURCES ” Practice Location

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