Provider Demographics
NPI: | 1760009765 |
---|---|
Name: | THE RECOVERY CONNECTION LLC |
Entity type: | Organization |
Organization Name: | THE RECOVERY CONNECTION LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF EXECUTIVE OFFICER |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | JULIE |
Authorized Official - Middle Name: | MARIE |
Authorized Official - Last Name: | FUNKHOUSER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 540-686-0864 |
Mailing Address - Street 1: | PO BOX 2724 |
Mailing Address - Street 2: | |
Mailing Address - City: | WINCHESTER |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 22604-1924 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 540-686-0864 |
Mailing Address - Fax: | 540-504-7818 |
Practice Address - Street 1: | 320 WESTSIDE STATION DR |
Practice Address - Street 2: | |
Practice Address - City: | WINCHESTER |
Practice Address - State: | VA |
Practice Address - Zip Code: | 22601-2839 |
Practice Address - Country: | US |
Practice Address - Phone: | 540-504-7671 |
Practice Address - Fax: | 540-504-7818 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-06-25 |
Last Update Date: | 2024-05-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | |
No | 251B00000X | Agencies | Case Management |