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NPI Code Detail

MEDICARE: TAYLOR RECOVERY CENTER

MEDICARE: TAYLOR RECOVERY CENTER
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
1101YA0400XAddiction (Substance Use Disorder) Counselor3856-3857TX

General Provider Information

NPI Number : 1720475007
Entity Type Code : Organization
Provider Name (Legal Business Name) : TAYLOR RECOVERY CENTER
Provider Business Mailing Address
First Line : PO BOX 1104
Second Line :
City : HUMBLE
State : TX
Zip : 77347-1104
Country : US
Telephone Number : 713-444-0614
Fax Number :
Provider Business Practice Location Address
First Line : 5715 LAVENDER ST
Second Line :
City : HOUSTON
State : TX
Zip : 77026-1725
Country : US
Telephone Number : 713-444-0614
Fax Number :
Authorized Official
Title or Position : OWNER
Name : KRISTI TAYLOR
Credential :
Telephone Number : 713-444-0614
Provider Enumeration Date : 04/23/2015
Last Update Date : 06/03/2015

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Directions to “TAYLOR RECOVERY CENTER ” Practice Location

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