MEDICARE: TRIBAL DRUM RECOVERY

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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1447048400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIBAL DRUM RECOVERY

Provider Business Mailing Address
First Line	:	10707 LAKE CREEK PKWY APT 16
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-1649
Country	:	US
Telephone Number	:	737-465-1360
Fax Number	:

Provider Business Practice Location Address
First Line	:	10707 LAKE CREEK PKWY APT 16
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-1649
Country	:	US
Telephone Number	:	737-465-1360
Fax Number	:

Authorized Official
Title or Position	:	COUNSELOR
Name	:	SILVIA ATIM
Credential	:	LCDC,LPC-A
Telephone Number	:	737-465-1360

Provider Enumeration Date	:	04/29/2025
Last Update Date	:	12/04/2025

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