MEDICARE: REAL 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

General Provider Information

NPI Number	:	1659126530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REAL RECOVERY SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	4411 BEE RIDGE RD
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34233-2514
Country	:	US
Telephone Number	:	813-373-6762
Fax Number	:

Provider Business Practice Location Address
First Line	:	4901 26TH ST W STE A
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34207-1708
Country	:	US
Telephone Number	:	813-541-4506
Fax Number	:

Authorized Official
Title or Position	:	CEO CFO
Name	:	PATRICK SLATTERY
Credential	:
Telephone Number	:	813-373-6762

Provider Enumeration Date	:	04/23/2024
Last Update Date	:	04/23/2024

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