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NPI Code Detail

MEDICARE: GUARDIAN RECOVERY DALLAS ADDICTION CENTER, LLC

MEDICARE: GUARDIAN RECOVERY DALLAS ADDICTION CENTER, 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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
2324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1699500199
Entity Type Code : Organization
Provider Name (Legal Business Name) : GUARDIAN RECOVERY DALLAS ADDICTION CENTER, LLC
Provider Business Mailing Address
First Line : 3333 S CONGRESS AVE STE 402
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33445-7346
Country : US
Telephone Number : 561-223-6469
Fax Number :
Provider Business Practice Location Address
First Line : 5217 VILLAGE CREEK DR
Second Line :
City : PLANO
State : TX
Zip : 75093-4416
Country : US
Telephone Number : 612-236-4695
Fax Number :
Authorized Official
Title or Position : CEO
Name : MR. JOSHUA SCOTT
Credential :
Telephone Number : 561-223-6469
Provider Enumeration Date : 09/04/2024
Last Update Date : 04/03/2025

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