Provider Demographics
NPI:1104469014
Name:ROCK RECOVERY, INC.
Entity type:Organization
Organization Name:ROCK RECOVERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:DONDERO
Authorized Official - Last Name:BETTWY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-255-9906
Mailing Address - Street 1:PO BOX 100923
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22210-3923
Mailing Address - Country:US
Mailing Address - Phone:712-559-9065
Mailing Address - Fax:
Practice Address - Street 1:1901 FORT MYER DR STE 1130
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22209-1606
Practice Address - Country:US
Practice Address - Phone:571-255-9906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable