Healthcare Provider Details

I. General information

NPI: 1295377570
Provider Name (Legal Business Name): DAYLIGHT RECOVERY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2019
Last Update Date: 10/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 QUEENSLAND CIR STE 101
CORONA CA
92879-1381
US

IV. Provider business mailing address

160 W FOOTHILL PKWY STE 105-186
CORONA CA
92882-8545
US

V. Phone/Fax

Practice location:
  • Phone: 833-232-9544
  • Fax:
Mailing address:
  • Phone: 833-232-9544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: CHRISTY L. DAY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 909-643-9578