Socal Recovery Centers, INC.
Substance Abuse Rehabilitation Facility in Malibu, CA. Organization (NPI-2).
NPI number1124456777
StatusActive
Last updated in NPPESOct 21, 2013
Details
- NPI
- 1124456777
- Entity type
- Organization (NPI-2)
- Legal business name
- Socal Recovery Centers, INC.
- Organization subpart
- No
- Enumeration date
- Oct 17, 2013
- Last updated
- Oct 21, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 324500000X | Substance Abuse Rehabilitation Facility | 190787AP | CA | Yes |
Other names
- Malibu Life Recovery Center (Doing Business As)
Practice location
6315 Bonsall DrMalibu, CA 90265-3827
Phone 310-699-7482
Mailing address
Po Box 197Lake Arrowhead, CA 92352-0197
Phone 310-699-7482
Authorized official
Jack Green
Owner
3106997482
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