Provider Demographics
NPI:1417595547
Name:FORWARD RECOVERY SOLUTIONS, LLC
Entity Type:Organization
Organization Name:FORWARD RECOVERY SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCREERY
Authorized Official - Suffix:
Authorized Official - Credentials:CADC II
Authorized Official - Phone:213-858-3786
Mailing Address - Street 1:9740 W PICO BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-4711
Mailing Address - Country:US
Mailing Address - Phone:213-858-3786
Mailing Address - Fax:
Practice Address - Street 1:1428 ROXBURY DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-2815
Practice Address - Country:US
Practice Address - Phone:213-858-3786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-19
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA190981BPOtherCOMMERCIAL INSURANCES