MEDICARE: QUALITY CARE RECOVERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	252Y00000X	Early Intervention Provider Agency
2	261QH0100X	Health Service Clinic/Center
3	261QR0400X	Rehabilitation Clinic/Center
4	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
5	261QR0800X	Recovery Care Clinic/Center
6	276400000X	Substance Use Disorder Rehabilitation Hospital Unit
7	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1972236172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY CARE RECOVERY

Provider Business Mailing Address
First Line	:	6258 S LA BREA AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90056-1913
Country	:	US
Telephone Number	:	213-924-5275
Fax Number	:

Provider Business Practice Location Address
First Line	:	9100 S SEPULVEDA BLVD STE 220
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-4850
Country	:	US
Telephone Number	:	213-924-5275
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. TAVACKUS DAWSON
Credential	:	RADT
Telephone Number	:	213-924-5275

Provider Enumeration Date	:	07/05/2022
Last Update Date	:	07/05/2022

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Directions to “QUALITY CARE RECOVERY ” Practice Location

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