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Organization

RECOVERY CONCEPTS URBANA, LLC

Active
Parent organization
RECOVERY CONCEPTS HOLDINGS, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
RECOVERY CONCEPTS HOLDINGS, LLC
Authorized official
DR. RICHARD MANKINEN MD (DIRECTOR)
(708) 335-1155
Entity
Organization

Contact information

Practice address
710 W. KILLARNEY ST., URBANA, IL 61801
(985) 705-3263
Mailing address
12489 JOSEPHS RD, FOLSOM, LA 70437-5829
(985) 705-3263

Taxonomy

Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A-3516-0001-A
SUPR ILLINOIS
IL
05
A-3516-0001-A
IL
Enumeration date
07/24/2020
Last updated
11/24/2020
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