Provider Demographics
NPI:1053945428
Name:RADICAL RECOVERY TREATMENT CENTER INC
Entity type:Organization
Organization Name:RADICAL RECOVERY TREATMENT CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FAISAL
Authorized Official - Middle Name:AWADALLA
Authorized Official - Last Name:AWADELKARIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-502-8035
Mailing Address - Street 1:9323 SLOANE ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23503-4329
Mailing Address - Country:US
Mailing Address - Phone:804-502-8035
Mailing Address - Fax:
Practice Address - Street 1:9323 SLOANE ST STE C
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23503-4329
Practice Address - Country:US
Practice Address - Phone:757-524-5544
Practice Address - Fax:833-606-0190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2023-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty