MEDICARE: RELENTLESS RECOVERY & WELLNESS, 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
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1578406872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RELENTLESS RECOVERY & WELLNESS, LLC

Provider Business Mailing Address
First Line	:	152 E MAIN ST
Second Line	:
City	:	JEROME
State	:	ID
Zip	:	83338-2333
Country	:	US
Telephone Number	:	208-539-8565
Fax Number	:

Provider Business Practice Location Address
First Line	:	152 E MAIN ST
Second Line	:
City	:	JEROME
State	:	ID
Zip	:	83338-2333
Country	:	US
Telephone Number	:	208-539-8565
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMANDA MARIE MCCROREY
Credential	:	SUDA
Telephone Number	:	208-595-9113

Provider Enumeration Date	:	04/11/2026
Last Update Date	:	05/18/2026

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