| Modern Recovery, Llc | |
|
702 Houston St # 118 Fort Worth TX 76102-5004 | |
| (203) 200-8556 | |
| Not Available |
| Full Name | Modern Recovery, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 702 Houston St # 118, Fort Worth, Texas |
| Authorized Official Name and Position | Laura Nuss (MEMBER) |
| Authorized Official Contact | 2032008556 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Recovery, Llc 11445 E Via Linda Ste 2-617 Scottsdale AZ 85259 Ph: () - | Modern Recovery, Llc 702 Houston St # 118 Fort Worth TX 76102-5004 Ph: (203) 200-8556 |
| NPI Number | 1417636309 |
|---|---|
| Provider Enumeration Date | 07/17/2023 |
| Last Update Date | 07/17/2023 |
| Certification Date | 07/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417636309 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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