Healthcare Provider Details

I. General information

NPI: 1952264582
Provider Name (Legal Business Name): BREA HILLS RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 OLINDA DR
BREA CA
92823-7040
US

IV. Provider business mailing address

629 BRIGHTVIEW DR
GLENDORA CA
91740-4145
US

V. Phone/Fax

Practice location:
  • Phone: 929-377-7897
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY MOON
Title or Position: CEO
Credential:
Phone: 407-773-0165