MEDICARE: JUST RECOVER PARTNERS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	106S00000X	Behavior Technician
3	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1811654783
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUST RECOVER PARTNERS LLC

Provider Business Mailing Address
First Line	:	3905 N 7TH AVE UNIT 7584
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85011-8026
Country	:	US
Telephone Number	:	623-518-0866
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 N CENTRAL AVE STE 122
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-2309
Country	:	US
Telephone Number	:	623-518-0866
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. JELANI JONES
Credential	:	CPSS
Telephone Number	:	623-518-0866

Provider Enumeration Date	:	11/26/2021
Last Update Date	:	11/26/2021

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Directions to “JUST RECOVER PARTNERS LLC ” Practice Location

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