Re-Creation Retreat Llc

LBN: Re-Creation Retreat Llc
Re-Creation Retreat Llc is an health care organization with primary practice located at 455 South Main , Fredonia AZ 86022. The organization recently has 2 registered licenses in different health care specialties including Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, Residential Treatment Facilities / Substance Abuse Rehabilitation Facility. Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness is the primary health care specialty. Re-Creation Retreat Llc can be contacted via phone (435) 691-0856, or through Soderquist, Randy K via phone (435) 691-0856.

Contact Information

Primary practice address
455 South Main Fredonia AZ 86022
Phone: (435) 691-0856
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Soderquist, Randy K Licensed Clinical Social Worker (LCSW)
Phone: (435) 691-0856

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X BH-3895 Arizona
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X BH-3895 Arizona

Profile Details

NPI number 1629339437
LBN Legal business name Re-Creation Retreat Llc
DBA Doing business as
Authorized official Soderquist, Randy K Licensed Clinical Social Worker (LCSW)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 7th, 2012
Last updated Nov 21st, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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