MEDICARE: RMD RECOVERY LLC

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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
2	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1619769387
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RMD RECOVERY LLC

Provider Business Mailing Address
First Line	:	405 E FAIRLANE DR
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-7207
Country	:	US
Telephone Number	:	605-513-5197
Fax Number	:	605-513-5198

Provider Business Practice Location Address
First Line	:	405 E FAIRLANE DR
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-7207
Country	:	US
Telephone Number	:	605-513-5197
Fax Number	:	605-513-5198

Authorized Official
Title or Position	:	CEO
Name	:	RYAN LETTERMAN
Credential	:
Telephone Number	:	714-615-7729

Provider Enumeration Date	:	05/20/2025
Last Update Date	:	10/29/2025

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