| Rooted In Recovery Therapeutic Services Llc | |
|
5 N Battery St Highland Springs VA 23075-1107 | |
| (804) 833-0467 | |
| (804) 616-4845 |
| Full Name | Rooted In Recovery Therapeutic Services Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5 N Battery St, Highland Springs, Virginia |
| Authorized Official Name and Position | Al Berry (MANAGER) |
| Authorized Official Contact | 4699154211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rooted In Recovery Therapeutic Services Llc Po Box 50451 Richmond VA 23250-0451 Ph: (804) 833-0467 | Rooted In Recovery Therapeutic Services Llc 5 N Battery St Highland Springs VA 23075-1107 Ph: (804) 833-0467 |
| NPI Number | 1841874237 |
|---|---|
| Provider Enumeration Date | 05/11/2021 |
| Last Update Date | 04/18/2024 |
| Certification Date | 04/18/2024 |
| Medicare PECOS PAC ID | 5890137426 |
|---|---|
| Medicare Enrollment ID | O20240528001572 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841874237 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Lichele Jw White |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366048191 PECOS PAC ID: 6709228331 Enrollment ID: I20240528001631 |
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