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	01-0435	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	010435	OTHER	OH	STATE OF OHIO MENTAL HEALTH CERTICATION
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922418748
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RECOVERY RESOURCES

Provider Business Mailing Address
First Line	:	4269 PEARL ROAD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-4259
Country	:	US
Telephone Number	:	216-431-4131
Fax Number	:	216-431-4151

Provider Business Practice Location Address
First Line	:	4269 PEARL ROAD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-4259
Country	:	US
Telephone Number	:	216-431-4131
Fax Number	:	216-431-4151

Authorized Official
Title or Position	:	CEO
Name	:	MS. PAM GILL
Credential	:
Telephone Number	:	216-431-4131

Provider Enumeration Date	:	05/01/2014
Last Update Date	:	11/02/2016

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Directions to “RECOVERY RESOURCES ” Practice Location

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