Provider Demographics
NPI:1730877283
Name:RECEPTIVE INC.
Entity type:Organization
Organization Name:RECEPTIVE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:BORG
Authorized Official - Last Name:COSTANZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-232-9240
Mailing Address - Street 1:2810 N CHURCH ST
Mailing Address - Street 2:PMB 79505
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-4447
Mailing Address - Country:US
Mailing Address - Phone:760-284-5368
Mailing Address - Fax:
Practice Address - Street 1:2810 N CHURCH ST
Practice Address - Street 2:PMB 79505
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-4447
Practice Address - Country:US
Practice Address - Phone:760-284-5368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty