Provider Demographics
NPI:1801514625
Name:THE RECOVERY CONNECT LLC
Entity type:Organization
Organization Name:THE RECOVERY CONNECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREATMENT DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:612-759-5742
Mailing Address - Street 1:1223 MAYWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55117-4133
Mailing Address - Country:US
Mailing Address - Phone:612-759-5742
Mailing Address - Fax:
Practice Address - Street 1:831 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55808-1913
Practice Address - Country:US
Practice Address - Phone:612-759-5742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty