MEDICARE: RECOVERY HEALTH OPTIONS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1013783976
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RECOVERY HEALTH OPTIONS, INC.

Provider Business Mailing Address
First Line	:	17602 17TRH ST.
Second Line	:	SUITE 102-123
City	:	TUSTIN
State	:	CA
Zip	:	92780
Country	:	US
Telephone Number	:	714-883-3133
Fax Number	:

Provider Business Practice Location Address
First Line	:	4029 WESTERLY PL STE 113
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-2329
Country	:	US
Telephone Number	:	714-875-5479
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. ZACHARY JOSEPH FIELDING
Credential	:
Telephone Number	:	714-875-5479

Provider Enumeration Date	:	11/30/2023
Last Update Date	:	04/25/2024

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