MEDICARE: FIRST CLASS RECOVERY 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1598431322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CLASS RECOVERY LLC

Provider Business Mailing Address
First Line	:	6919 CATALPA SPRINGS DR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40228-2393
Country	:	US
Telephone Number	:	502-314-1342
Fax Number	:

Provider Business Practice Location Address
First Line	:	729 NW 2ND ST APT 828
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33128-1472
Country	:	US
Telephone Number	:	502-314-1342
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	CONSTANCE M LYONS
Credential	:	APRN
Telephone Number	:	502-314-1342

Provider Enumeration Date	:	08/20/2021
Last Update Date	:	09/06/2023

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Directions to “FIRST CLASS RECOVERY LLC ” Practice Location

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