MEDICARE: TRUE CARE TREATMENT CENTERS 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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1548740418
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUE CARE TREATMENT CENTERS LLC

Provider Business Mailing Address
First Line	:	303 MERRICK RD STE 301
Second Line	:
City	:	LYNBROOK
State	:	NY
Zip	:	11563-2501
Country	:	US
Telephone Number	:	718-360-3611
Fax Number	:

Provider Business Practice Location Address
First Line	:	2901 N TENAYA WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1420
Country	:	US
Telephone Number	:	516-697-9430
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/ CEO
Name	:	STEVEN MOLLER
Credential	:
Telephone Number	:	516-887-2962

Provider Enumeration Date	:	08/20/2018
Last Update Date	:	08/20/2018

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