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Organization

MARTIN'S RECOVERY CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARTIN JOHN NIEVES LCDC (PRESIDENT)
(817) 717-4983
Entity
Organization

Contact information

Practice address
1456 SIERRA SPRINGS DR, APT 811, BEDFORD, TX 76021-7646
(817) 717-4983
Mailing address
1456 SIERRA SPRINGS DR, APT 811, BEDFORD, TX 76021-7646
(817) 717-4983

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13296
TX
251B00000X
Case Management Agency
13296
TX

Other

Enumeration date
08/24/2016
Last updated
08/24/2016
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