MEDICARE: CALIFORNIA RECOVERY CENTER

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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
2	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1437915923
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALIFORNIA RECOVERY CENTER

Provider Business Mailing Address
First Line	:	920 RESERVE DR STE 180
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95678-1382
Country	:	US
Telephone Number	:
Fax Number	:	916-435-6400

Provider Business Practice Location Address
First Line	:	920 RESERVE DR STE 140
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95678-1381
Country	:	US
Telephone Number	:	855-936-2359
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	WILLIAM MENTESH
Credential	:
Telephone Number	:	916-622-4017

Provider Enumeration Date	:	02/22/2024
Last Update Date	:	06/18/2026

Similar Medicare Providers

1851190656 — NAOMI GOMEZ
Practice Location Address:

6783 MAPLE CREEK DR
ROSEVILLE, CA
95678-3451

Practice Phone: 408-726-5717
Practice Fax:

1710449350 — CALIFORNIA RECOVERY CENTER
Practice Location Address:

423 OAK ST
ROSEVILLE, CA
95678-2618

Practice Phone: 855-936-2359
Practice Fax: 916-435-6400

1386464006 — LINDSEY ELISE NISTOR
Practice Location Address:

6925 CHERRY RIDGE CIR
ROSEVILLE, CA
95678-3445

Practice Phone: 916-588-0539
Practice Fax:

1154795987 — EMILIO RAMIREZ
Practice Location Address:

716 PLEASANT ST.
ROSEVILLE, CA
95678

Practice Phone: 916-521-8583
Practice Fax:

1508790312 — RACHEL WIGGS
Practice Location Address:

1382 BLUE OAKS BLVD STE 213
ROSEVILLE, CA
95678-7052

Practice Phone: 619-940-5165
Practice Fax:

1730013806 — MACKENZIE FOX
Practice Location Address:

1358 BLUE OAKS BLVD STE 300
ROSEVILLE, CA
95678-7040

Practice Phone: 916-676-0488
Practice Fax:

Directions to “CALIFORNIA RECOVERY CENTER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.