Provider Demographics
NPI:1568827418
Name:RECOVERY GRADS, LLC
Entity type:Organization
Organization Name:RECOVERY GRADS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:CARVALHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-514-9268
Mailing Address - Street 1:1015 GAYLEY AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-3475
Mailing Address - Country:US
Mailing Address - Phone:310-822-1234
Mailing Address - Fax:213-737-3059
Practice Address - Street 1:3077 UNIVERSITY AVE STE 105
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90007-3717
Practice Address - Country:US
Practice Address - Phone:310-480-7129
Practice Address - Fax:805-584-9651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-19
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility