MEDICARE: CHRISTIAN RECOVERY CENTER'S INC

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	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1659958171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTIAN RECOVERY CENTER'S INC

Provider Business Mailing Address
First Line	:	PO BOX 3091
Second Line	:
City	:	SHALLOTTE
State	:	NC
Zip	:	28459-3091
Country	:	US
Telephone Number	:	910-287-4357
Fax Number	:	910-287-6603

Provider Business Practice Location Address
First Line	:	1994 ASH LITTLE RIVER RD NW
Second Line	:
City	:	ASH
State	:	NC
Zip	:	28420-1804
Country	:	US
Telephone Number	:	910-287-4357
Fax Number	:	910-287-6603

Authorized Official
Title or Position	:	CEO
Name	:	MR. JOSHUA A TORBICH
Credential	:	CPSS
Telephone Number	:	919-389-9935

Provider Enumeration Date	:	03/29/2021
Last Update Date	:	03/29/2021

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