| Recover. Restart. Refreshed, Inc. | |
|
1882 Capital Cir Ne Ste 205 Tallahassee FL 32308-4568 | |
| (888) 718-4915 | |
| (850) 765-7597 |
| Full Name | Recover. Restart. Refreshed, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 1882 Capital Cir Ne Ste 205, Tallahassee, Florida |
| Authorized Official Name and Position | Da'shaneka Wright (CO-EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8502220552 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Recover. Restart. Refreshed, Inc. 1882 Capital Cir Ne Ste 205 Tallahassee FL 32308-4568 Ph: (888) 718-4915 | Recover. Restart. Refreshed, Inc. 1882 Capital Cir Ne Ste 205 Tallahassee FL 32308-4568 Ph: (888) 718-4915 |
| NPI Number | 1275053613 |
|---|---|
| Provider Enumeration Date | 06/27/2017 |
| Last Update Date | 08/18/2022 |
| Certification Date | 08/18/2022 |
| Medicare PECOS PAC ID | 2264863992 |
|---|---|
| Medicare Enrollment ID | O20200514000082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275053613 | NPI | - | NPPES |
| 111727700 | Medicaid | FL |
| Provider Name | Precious L Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083135990 PECOS PAC ID: 3173954807 Enrollment ID: I20200514000111 |
| Provider Name | Ivory Monique Avant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508387416 PECOS PAC ID: 5193136463 Enrollment ID: I20201118001998 |
| Provider Name | Anzola Wiggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154092245 PECOS PAC ID: 3173912342 Enrollment ID: I20211109000777 |
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