| The Recovery Clinic Llc | |
|
7117 Ohms Ln Edina MN 55439-2142 | |
| (612) 309-1022 | |
| Not Available |
| Full Name | The Recovery Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7117 Ohms Ln, Edina, Minnesota |
| Authorized Official Name and Position | Jason Reed (PRESIDENT) |
| Authorized Official Contact | 6123091022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Recovery Clinic Llc 7117 Ohms Ln Edina MN 55439-2142 Ph: (763) 577-2489 | The Recovery Clinic Llc 7117 Ohms Ln Edina MN 55439-2142 Ph: (612) 309-1022 |
| NPI Number | 1689190019 |
|---|---|
| Provider Enumeration Date | 08/17/2017 |
| Last Update Date | 11/19/2022 |
| Certification Date | 11/19/2022 |
| Medicare PECOS PAC ID | 0042569113 |
|---|---|
| Medicare Enrollment ID | O20180822002971 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689190019 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jason Dean Reed |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306175443 PECOS PAC ID: 4385818327 Enrollment ID: I20111201000023 |
| Provider Name | Eva S Reed |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376826354 PECOS PAC ID: 6002073855 Enrollment ID: I20120206000655 |
| Provider Name | Jodi M Arns |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376818328 PECOS PAC ID: 0244496438 Enrollment ID: I20120716000046 |
| Provider Name | Joshua W Meendering |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497108864 PECOS PAC ID: 8921333584 Enrollment ID: I20190718001771 |
| Provider Name | Paige Elizabeth Jacobsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396374815 PECOS PAC ID: 5193140507 Enrollment ID: I20200803000436 |
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