MEDICARE: SMART CHOICE RECOVERY 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	251S00000X	Community/Behavioral Health Agency	3231-3232	TX

General Provider Information

NPI Number	:	1366773327
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMART CHOICE RECOVERY INC

Provider Business Mailing Address
First Line	:	1112 HANSON CT
Second Line	:
City	:	GLENN HEIGHTS
State	:	TX
Zip	:	75154-8808
Country	:	US
Telephone Number	:	972-800-6986
Fax Number	:	214-376-3034

Provider Business Practice Location Address
First Line	:	400 N SAINT PAUL ST
Second Line	:	SUITE 1050
City	:	DALLAS
State	:	TX
Zip	:	75201-3114
Country	:	US
Telephone Number	:	972-800-6986
Fax Number	:	214-376-3034

Authorized Official
Title or Position	:	CEO
Name	:	MRS. DONNITA SMART
Credential	:	LCDC
Telephone Number	:	972-800-6986

Provider Enumeration Date	:	01/14/2010
Last Update Date	:	01/14/2010

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