MEDICARE: ECHO TREATMENT 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	261QM2800X	Methadone Clinic	637041	PA

General Provider Information

NPI Number	:	1992170930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ECHO TREATMENT CENTER, LLC

Provider Business Mailing Address
First Line	:	1720 LAKEPOINTE DR STE 117
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75057-6425
Country	:	US
Telephone Number	:	469-470-4779
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 E WYLIE AVE STE 2
Second Line	:
City	:	WASHINGTON
State	:	PA
Zip	:	15301-2059
Country	:	US
Telephone Number	:	724-222-6220
Fax Number	:	724-222-6221

Authorized Official
Title or Position	:	VP, TREASURER
Name	:	BRUCE JARVIE
Credential	:
Telephone Number	:	214-379-3300

Provider Enumeration Date	:	12/02/2015
Last Update Date	:	07/29/2024

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