Black Rock Recovery, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

BLACK ROCK RECOVERY, LLC

Practice address

25235 Orchard Lake Rd
Farmington Hills, MI 48336-1233

Phone

(248) 252-6192

NPI assigned

Feb 11, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eni V Smith, MD

Title

Partner

Phone

(248) 252-6192

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581638400000",
    "number": "1417589086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25235 ORCHARD LAKE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483361233",
            "telephone_number": "248-252-6192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25235 ORCHARD LAKE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483361233",
            "telephone_number": "248-252-6192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK ROCK RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-11",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ENI",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "248-252-6192",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Bivins
• Nicole Biwer
• Chelsea Bizimana
• Laila Bizzell
• Cortnee Blach
• Brianna Monet' Black-Clanton
• Abbey Black
• Angel Black
• Anthony Black
• Ashley N. Black

• Substance Use Disorder Rehabilitation Clinic/Center in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.