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NPI Code Detail

MEDICARE: SPENCER RECOVERY CENTERS, INC.

MEDICARE: SPENCER RECOVERY CENTERS, 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
1324500000XSubstance Abuse Rehabilitation Facility300088APCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ZZZ60436ZOTHERCABLUE SHIELD OF CA

General Provider Information

NPI Number : 1831284843
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPENCER RECOVERY CENTERS, INC.
Provider Business Mailing Address
First Line : PO BOX 9296
Second Line :
City : LAGUNA BEACH
State : CA
Zip : 92652-7261
Country : US
Telephone Number : 800-334-0394
Fax Number : 949-313-5222
Provider Business Practice Location Address
First Line : 1316 S COAST HWY
Second Line :
City : LAGUNA BEACH
State : CA
Zip : 92651-3118
Country : US
Telephone Number : 800-334-0394
Fax Number : 949-313-5222
Authorized Official
Title or Position : COO
Name : CINDY SALO GARCIA
Credential :
Telephone Number : 949-313-5240
Provider Enumeration Date : 10/04/2006
Last Update Date : 04/05/2018

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Directions to “SPENCER RECOVERY CENTERS, INC. ” Practice Location

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