MEDICARE: TRUE RECOVERY AND TREATMENT 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
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1700243938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUE RECOVERY AND TREATMENT CENTER, LLC

Provider Business Mailing Address
First Line	:	2328 10TH AVE N
Second Line	:	SUITE 104
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-6606
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2328 10TH AVE N
Second Line	:	SUITE 104
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-6606
Country	:	US
Telephone Number	:	561-619-2596
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CECELIA MURRY
Credential	:
Telephone Number	:	561-619-2596

Provider Enumeration Date	:	01/19/2016
Last Update Date	:	01/19/2016

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