MEDICARE: THE SOLACE 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	1041C0700X	Clinical Social Worker	33089	TX
2	2084P0800X	Psychiatry Physician	P0585	TX

General Provider Information

NPI Number	:	1912385592
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE SOLACE CENTER, LLC

Provider Business Mailing Address
First Line	:	4502 RIVERSTONE BLVD
Second Line	:	SUITE # 601
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-5200
Country	:	US
Telephone Number	:	281-778-9530
Fax Number	:

Provider Business Practice Location Address
First Line	:	4502 RIVERSTONE BLVD
Second Line	:	SUITE # 601
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-5200
Country	:	US
Telephone Number	:	281-778-9530
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MS. ERICA LAINE BRUCE
Credential	:	LCSW
Telephone Number	:	281-778-9530

Provider Enumeration Date	:	05/14/2015
Last Update Date	:	02/23/2023

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Directions to “THE SOLACE CENTER, LLC ” Practice Location

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