Provider Demographics
NPI:1922811157
Name:TRIPLE R RECOVERY LLC
Entity type:Organization
Organization Name:TRIPLE R RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUBSTANCE USE DISORDER COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MATTIX
Authorized Official - Suffix:
Authorized Official - Credentials:CADC
Authorized Official - Phone:208-615-7599
Mailing Address - Street 1:21985 DIXIE RIVER RD # 102
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83607-9027
Mailing Address - Country:US
Mailing Address - Phone:208-615-7599
Mailing Address - Fax:
Practice Address - Street 1:21985 DIXIE RIVER RD # 102
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83607-9027
Practice Address - Country:US
Practice Address - Phone:208-615-7599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty