| Organization Name: | LARRY FRITZLAN RECOVERY SERVICES, INC. |
| NPI Number: | 1154752012 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LARRY FRITZLAN (OWNER) |
| Mailing Address: | 21 Tamal Vista Blvd Suite 226 Corte Madera |
| State: | CA US |
| Postal Code: | 949251130 |
| Phone Number: | 4159450923 |
| Fax Number: | |
| NPI Enumeration Date: | 12/03/2013 |
| NPI Last Update Date: | 12/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |