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NPI Code Detail

MEDICARE: RECOVERY CONNECTIONS TREATMENT SERVICES

MEDICARE: RECOVERY CONNECTIONS TREATMENT SERVICES
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
1324500000XSubstance Abuse Rehabilitation Facility430057BPCA

General Provider Information

NPI Number : 1851550362
Entity Type Code : Organization
Provider Name (Legal Business Name) : RECOVERY CONNECTIONS TREATMENT SERVICES
Provider Business Mailing Address
First Line : 1723 HAMILTON AVE STE D
Second Line :
City : SAN JOSE
State : CA
Zip : 95125-5428
Country : US
Telephone Number : 408-264-9200
Fax Number : 408-264-9209
Provider Business Practice Location Address
First Line : 1723 HAMILTON AVE STE D
Second Line :
City : SAN JOSE
State : CA
Zip : 95125-5428
Country : US
Telephone Number : 408-264-9200
Fax Number : 408-264-9209
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. IVEY IKE GROZIER III
Credential : M.A., CADCA
Telephone Number : 408-264-9200
Provider Enumeration Date : 06/09/2008
Last Update Date : 06/09/2008

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Directions to “RECOVERY CONNECTIONS TREATMENT SERVICES ” Practice Location

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