REVOLUTIONARY RECOVERY NPI 1013605591

NPI Information

  • NPI: 1013605591
  • Provider Name: REVOLUTIONARY RECOVERY
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Address: 799 LONG HILL RD APT D
    MIDDLETOWN, CT
    ZIP 06457
  • Phone: (860) 558-4226

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NPI Details

REVOLUTIONARY RECOVERY is a clinic center in Middletown, CT. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). REVOLUTIONARY RECOVERY NPI is 1013605591. The provider is registered as an organization entity type.

The provider's business location address is:

799 LONG HILL RD APT D
MIDDLETOWN, CT
ZIP 06457-011
Phone: (860) 558-4226

The provider's authorized official is Jena Mitchell .
The authorized official title is Nurse Practitioner and has the following contact phone number (860) 558-4226.

The enumeration date for this NPI number is 4/24/2023 and was last updated on 4/24/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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