Healthcare Provider Details

I. General information

NPI: 1417873449
Provider Name (Legal Business Name): BIG IKES RECOVERY HEALTH SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2832 WESTWIND CIR APT 1107
FORT WORTH TX
76116-2952
US

IV. Provider business mailing address

2832 WESTWIND CIR APT 1107
FORT WORTH TX
76116-2952
US

V. Phone/Fax

Practice location:
  • Phone: 817-210-8620
  • Fax:
Mailing address:
  • Phone: 817-210-8620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DENNIS SWANSON
Title or Position: OWNER AND CEO
Credential:
Phone: 817-210-8620