MEDICARE: AFFIRM RECOVERY CENTER, INC

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
2	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1861359440
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFIRM RECOVERY CENTER, INC

Provider Business Mailing Address
First Line	:	5555 N LAMAR BLVD STE D105
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78751-1055
Country	:	US
Telephone Number	:	512-230-7905
Fax Number	:

Provider Business Practice Location Address
First Line	:	5555 N LAMAR BLVD STE D105
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78751-1055
Country	:	US
Telephone Number	:	512-230-7905
Fax Number	:

Authorized Official
Title or Position	:	VP OF FINANCE
Name	:	LETICIA ANN NINO
Credential	:
Telephone Number	:	512-230-7905

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	02/17/2026

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