MEDICARE: FORWARD RECOVERY SOLUTIONS, 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	324500000X	Substance Abuse Rehabilitation Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	190981BP	OTHER	CA	COMMERCIAL INSURANCES

General Provider Information

NPI Number	:	1417595547
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORWARD RECOVERY SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	9740 W PICO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-4711
Country	:	US
Telephone Number	:	213-858-3786
Fax Number	:

Provider Business Practice Location Address
First Line	:	1428 ROXBURY DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-2815
Country	:	US
Telephone Number	:	213-858-3786
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. LONNIE MCCREERY
Credential	:	CADC II
Telephone Number	:	213-858-3786

Provider Enumeration Date	:	12/19/2019
Last Update Date	:	12/09/2025

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Directions to “FORWARD RECOVERY SOLUTIONS, LLC ” Practice Location

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