Realcovery LLC

Primary specialty

Lodging ProviderTaxonomy code 177F00000X

Legal business name

REALCOVERY LLC

Practice address

2091 4TH Ave E
Twin Falls, ID 83301-7405

Phone

(208) 731-7354

NPI assigned

Oct 8, 2024

Organization subpart

No

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

Authorized official

Name

Taylor Watte

Title

Administrator

Phone

(503) 989-9180

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728345600000",
    "number": "1609695477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2067 4TH AVE E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833017405",
            "telephone_number": "503-989-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2091 4TH AVE E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833017405",
            "telephone_number": "208-731-7354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 4th Ave E",
            "address_purpose": "LOCATION",
            "city": "Twin Falls",
            "state": "ID",
            "postal_code": "833016312",
            "country_code": "US",
            "telephone_number": "208-731-7354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "676 Shoup Ave W",
            "address_purpose": "LOCATION",
            "city": "Twin Falls",
            "state": "ID",
            "postal_code": "833016096",
            "country_code": "US",
            "telephone_number": "208-731-7354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REALCOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A",
        "authorized_official_last_name": "WATTE",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "503-989-9180"
    },
    "taxonomies": [
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.