Recovery 369 LLC

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Legal business name

RECOVERY 369 LLC

Doing business as

Recovery 369

Practice address

7411 Aspect Dr Unit 103
Granger, IN 46530-7755

Phone

(574) 369-9664

NPI assigned

Sep 8, 2023

Last updated

Sep 11, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Roberto M Cardona Jr., CAPRC II

Title

Owner / Recovery Coach

Phone

(574) 369-9664

Specialties & licenses 1

Addresses

Other names 1

• Recovery 369 Doing business as

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

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1982481594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7411 ASPECT DR UNIT 103",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465307755",
            "telephone_number": "574-369-9664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7411 ASPECT DR UNIT 103",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465307755",
            "telephone_number": "574-369-9664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECOVERY 369 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-08",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "CARDONA",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER / RECOVERY COACH",
        "authorized_official_telephone_number": "574-369-9664",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "CAPRC II"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Recovery 369",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Peer Specialist in Granger, IN
• Providers in Granger, IN by specialty
• Peer Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.