Organization
ASIC RECOVERY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEA PHAM (OWNER)
(832) 681-9643
Entity
Organization
Contact information
Practice address
3256 LACKLAND RD, FORT WORTH, TX 76116-5307
(817) 616-0504
(817) 616-0758
Mailing address
3256 LACKLAND RD, FORT WORTH, TX 76116-5307
(832) 681-9643
(817) 616-0758
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/04/2021
Last updated
06/17/2026
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