Damascus Road, LLC
Substance Abuse Rehabilitation Facility in Anaheim, CA. Organization (NPI-2).
NPI number1154875185
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1154875185
- Entity type
- Organization (NPI-2)
- Legal business name
- Damascus Road, LLC
- Organization subpart
- No
- Enumeration date
- Aug 8, 2016
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 324500000X | Substance Abuse Rehabilitation Facility | 300656AP | CA | Yes |
Other names
- Bridges To Life Detox (Doing Business As)
Practice location
1313 N Brookhurst StAnaheim, CA 92801-1646
Phone 559-601-6065
Mailing address
Po Box 2496Fullerton, CA 92837-0496
Phone 559-601-6065
Authorized official
Kelly Smith
Office Coordinator
5596016065
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