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Provider Information for 1427657642

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

RECOVERY RANGER CORPS

Organization Subpart: NO

Organization NPI: 1427657642

Calendar   Last Updated:  2020-10-19
  Certification Date:  2020-10-19

Details

Name Value
NPI 1427657642
Enumeration Date 2020-10-19
NPI Type 2- Organization
Status Active
Authorized Official Information Name: MR. GABRIEL J KANAWITE
Title: PRESIDENT
Phone: 210-683-3131
Mailing Address 3426 SHORESIDE DR
GARLAND, TX 75043-1964
United States

Phone: 210-683-3131 | Fax:
View Map External Link
Primary Practice Address 3426 SHORESIDE DR
GARLAND, TX 75043-1964
United States

Phone: 210-683-3131 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Direct Messaging Address recoveryRangerCorps@pm.me ProtonMail me or Private Message me Health Information Exchange (HIE) CSV 3426 SHORESIDE DR
GARLAND, TX 75043-1964
United States
Other Identifiers
Issuer State Number
MEDICAID TX A8467929
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 324500000X - Substance Abuse Rehabilitation Facility
No 251V00000X - Voluntary or Charitable