Provider Demographics
NPI:1538546700
Name:RECOVERY HEALTHCARE AGENCY
Entity type:Organization
Organization Name:RECOVERY HEALTHCARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NGOZI
Authorized Official - Middle Name:REGINA
Authorized Official - Last Name:EZE
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:919-423-5513
Mailing Address - Street 1:3611 RANBIR DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-1792
Mailing Address - Country:US
Mailing Address - Phone:919-423-5513
Mailing Address - Fax:
Practice Address - Street 1:1717 S MIAMI BLVD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-5629
Practice Address - Country:US
Practice Address - Phone:919-423-5513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RECOVERY HEALTHCARE AGENCY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-27
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care