Provider Demographics
NPI:1366894438
Name:IRECOVER
Entity type:Organization
Organization Name:IRECOVER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RELIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:805-631-5268
Mailing Address - Street 1:607 PLAZA DR STE C102
Mailing Address - Street 2:SUITE C202
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-6945
Mailing Address - Country:US
Mailing Address - Phone:805-631-5268
Mailing Address - Fax:
Practice Address - Street 1:607 PLAZA DR STE C102
Practice Address - Street 2:SUITE C202
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-6945
Practice Address - Country:US
Practice Address - Phone:805-631-5268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health