Organization
FORT WORTH RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN JANEIRO (PRESIDENT/CEO)
(850) 491-4993
Entity
Organization
Contact information
Practice address
329 S HENDERSON ST, FORT WORTH, TX 76104-1042
(850) 491-4993
Mailing address
329 S HENDERSON ST, FORT WORTH, TX 76104-1042
(850) 491-4993
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
07/26/2021
Last updated
07/26/2021
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