# ROOTS TO RECOVERY COLLECTIVE LLC

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

## Provider details

- **NPI number:** 1477349900
- **Authorized official:** MICHAEL GAYMAN CADC (OWNER)
- **Authorized official phone:** (563) 505-5621

## Contact information

- **Practice address:** 1411 BRADY ST, DAVENPORT, IA 52803-4603
- **Practice address phone:** (563) 505-5621
- **Mailing address:** 1411 BRADY ST, DAVENPORT, IA 52803-4603
- **Mailing address phone:** (563) 505-5621

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |

## Other

- **Enumeration date:** 04/21/2025
- **Last updated:** 04/21/2025