Organization · NPI-2

Canyon House Recovery

Substance Abuse Rehabilitation Facility · Lake Forest, CA

NPI number1366128944
StatusActive
Last updated in NPPESJun 27, 2023

Details

NPI
1366128944
Entity type
Organization (NPI-2)
Legal business name
Canyon House Recovery
Organization subpart
No
Enumeration date
Jun 27, 2023
Certification date
Jun 27, 2023
Last updated
Jun 27, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
324500000X Substance Abuse Rehabilitation Facility––Yes

Practice location

23652 Cavanaugh Rd
Lake Forest, CA 92630-3736

Phone 949-506-6983

Mailing address

34145 Pacific Coast Hwy # 116
Dana Point, CA 92629-2731

Authorized official

Robert Lamattina
Compliance Manager
9495066983

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