MODERN RECOVERY LLC NPI 1417636309

NPI Information

NPI: 1417636309
Provider Name: MODERN RECOVERY, LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
702 HOUSTON ST # 118
FORT WORTH, TX
ZIP 76102
Phone: (203) 200-8556
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MODERN RECOVERY, LLC is a mental health (including community mental health center) clinic center in Fort Worth, TX. MODERN RECOVERY, LLC NPI is 1417636309. The provider is registered as an organization entity type.

The provider's business location address is:

702 HOUSTON ST # 118
FORT WORTH, TX
ZIP 76102-004
Phone: (203) 200-8556

The provider's authorized official is Laura Nuss .
The authorized official title is Member and has the following contact phone number (203) 200-8556.

The enumeration date for this NPI number is 7/17/2023 and was last updated on 7/17/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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