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NPI Code Detail

MEDICARE: REAL RECOVERY LLC

MEDICARE: REAL 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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YP2500XProfessional Counselor
3103T00000XPsychologist
41041C0700XClinical Social Worker
5207LA0401XAddiction Medicine (Anesthesiology) Physician
6207RA0401XAddiction Medicine (Internal Medicine) Physician
7363LF0000XFamily Nurse Practitioner
8363LP0808XPsychiatric/Mental Health Nurse Practitioner
9163W00000XRegistered Nurse
10106H00000XMarriage & Family Therapist
11207QA0401XAddiction Medicine (Family Medicine) Physician

General Provider Information

NPI Number : 1982060927
Entity Type Code : Organization
Provider Name (Legal Business Name) : REAL RECOVERY LLC
Provider Business Mailing Address
First Line : 1623 FOXHAVEN DR
Second Line :
City : RICHMOND
State : KY
Zip : 40475-1056
Country : US
Telephone Number : 859-625-5235
Fax Number : 859-625-5237
Provider Business Practice Location Address
First Line : 1623 FOXHAVEN DR
Second Line :
City : RICHMOND
State : KY
Zip : 40475-1056
Country : US
Telephone Number : 859-625-5235
Fax Number : 859-625-5237
Authorized Official
Title or Position : OWNER
Name : REBECCA SPERRY
Credential : R.N.
Telephone Number : 859-625-5235
Provider Enumeration Date : 01/06/2016
Last Update Date : 01/06/2016

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