MEDICARE: RECOVERY HOUSE 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	276400000X	Substance Use Disorder Rehabilitation Hospital Unit

General Provider Information

NPI Number	:	1639988801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RECOVERY HOUSE LLC

Provider Business Mailing Address
First Line	:	3510 COOPER RD
Second Line	:
City	:	BLUE ASH
State	:	OH
Zip	:	45241-3321
Country	:	US
Telephone Number	:	513-578-2965
Fax Number	:

Provider Business Practice Location Address
First Line	:	423 ARLINGTON AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-4612
Country	:	US
Telephone Number	:	513-578-2965
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KEVIN MARTIN
Credential	:
Telephone Number	:	513-578-2965

Provider Enumeration Date	:	01/02/2025
Last Update Date	:	01/02/2025

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Directions to “RECOVERY HOUSE LLC ” Practice Location

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