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General NPI Number Information
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NPI Number | 1952779985
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Entity Type | Organization
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Legal Business Name | INFINITE RECOVERY LLC
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Dates
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Enumeration Date | 09/08/2015
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Last Update Date | 09/08/2015
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Provider Practice Location Address
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Address Line | 7517 CAMERON RD STE 118
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City | AUSTIN
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State | TX
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Zip | 78752-2053
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Country | US
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Telephone | 512-358-4088
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Fax |
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Provider Business Mailing Address
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Address Line | 7517 CAMERON RD STE 118
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City | AUSTIN
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State | TX
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Zip | 78752-2053
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Country | US
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Telephone | 512-358-4088
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | GAIL ZORNE
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Credential |
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Telephone | 512-358-4088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 3767-3768
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License Number State | TX
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