Provider Demographics
NPI:1447133962
Name:RUCKMAN RECOVERY LLC
Entity type:Organization
Organization Name:RUCKMAN RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:RUCKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LCAC
Authorized Official - Phone:317-440-7995
Mailing Address - Street 1:625 N FORD RD
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-1245
Mailing Address - Country:US
Mailing Address - Phone:317-440-7995
Mailing Address - Fax:
Practice Address - Street 1:625 N FORD RD
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-1245
Practice Address - Country:US
Practice Address - Phone:317-440-7995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health