MEDICARE: RECOVERY RESOURCES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	3192	TX

General Provider Information

NPI Number	:	1154753648
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RECOVERY RESOURCES

Provider Business Mailing Address
First Line	:	1235 NORTH LOOP W
Second Line	:	SUITE 1008
City	:	HOUSTON
State	:	TX
Zip	:	77008-1758
Country	:	US
Telephone Number	:	713-426-4900
Fax Number	:	713-426-4901

Provider Business Practice Location Address
First Line	:	1235 NORTH LOOP W
Second Line	:	SUITE 1008
City	:	HOUSTON
State	:	TX
Zip	:	77008-1758
Country	:	US
Telephone Number	:	713-426-4900
Fax Number	:	713-426-4901

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MARVIN FORREST
Credential	:	LCDC
Telephone Number	:	713-426-4900

Provider Enumeration Date	:	08/06/2013
Last Update Date	:	08/06/2013

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Directions to “RECOVERY RESOURCES ” Practice Location

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