| NPI | 1053035774 |
|---|---|
| Other Name | RECOVIA LLC GRANT RD |
| Entity Type | Organization |
| Authorized Contact | CINDY PROFFITT Director Of Billing 480-219-7178 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| 103TC0700X Psychologist Clinical | |
| 103TP0016X Psychologist Prescribing (Medical) | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2022-09-27 |
| Last Update Date | 2023-08-11 |