MEDICARE: TREE HOUSE RECOVERY CO, 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	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1679282511
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TREE HOUSE RECOVERY CO, INC.

Provider Business Mailing Address
First Line	:	1640 SUPERIOR AVE
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92627-3652
Country	:	US
Telephone Number	:	855-202-2138
Fax Number	:

Provider Business Practice Location Address
First Line	:	3755 WAZEE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80216-3639
Country	:	US
Telephone Number	:	720-640-0202
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	MR. CLAYTON MCMILLEN
Credential	:
Telephone Number	:	808-341-2424

Provider Enumeration Date	:	11/18/2022
Last Update Date	:	11/18/2022

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