# RECOVERY SPACE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225894017
- **Authorized official:** YOLA VITAL (OWNER)
- **Authorized official phone:** (908) 764-4513

## Contact information

- **Practice address:** 1535 N CARLISLE ST, PHILADELPHIA, PA 19121-4314
- **Practice address phone:** (855) 766-3494
- **Mailing address:** 1535 N CARLISLE ST, PHILADELPHIA, PA 19121-4314
- **Mailing address phone:** (855) 766-3494

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |

## Other

- **Enumeration date:** 02/28/2024
- **Last updated:** 02/28/2024