MEDICARE: AMANA RECOVERY 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	261Q00000X	Clinic/Center
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1942061395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMANA RECOVERY LLC

Provider Business Mailing Address
First Line	:	4220 CARTWRIGHT RD STE 303
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-5309
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4220 CARTWRIGHT RD STE 303
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-5309
Country	:	US
Telephone Number	:	832-358-4820
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FLAVIA THOMAS
Credential	:
Telephone Number	:	832-358-4820

Provider Enumeration Date	:	01/22/2024
Last Update Date	:	01/23/2024

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