MEDICARE: FIRST CITY RECOVERY HOUSTON, LLC

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	323P00000X	Psychiatric Residential Treatment Facility
2	324500000X	Substance Abuse Rehabilitation Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1396498044	OTHER		NPI

General Provider Information

NPI Number	:	1396498044
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CITY RECOVERY HOUSTON, LLC

Provider Business Mailing Address
First Line	:	317 W JEFFERSON ST
Second Line	:
City	:	KOKOMO
State	:	IN
Zip	:	46901-4437
Country	:	US
Telephone Number	:	517-993-4416
Fax Number	:

Provider Business Practice Location Address
First Line	:	1006 WINDSOR LAKES BLVD STE 200
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77384-4975
Country	:	US
Telephone Number	:	517-993-4416
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	REESA MOSLEY
Credential	:
Telephone Number	:	517-993-4416

Provider Enumeration Date	:	02/02/2022
Last Update Date	:	11/20/2025

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Directions to “FIRST CITY RECOVERY HOUSTON, LLC ” Practice Location

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