Healthcare Provider Details

I. General information

NPI: 1740469113
Provider Name (Legal Business Name): SOCIAL MODEL RECOVERY SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2007
Last Update Date: 03/01/2024
Certification Date: 03/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11046 MAIN ST
EL MONTE CA
91731-2617
US

IV. Provider business mailing address

223 E ROWLAND ST
COVINA CA
91723-3147
US

V. Phone/Fax

Practice location:
  • Phone: 626-636-2370
  • Fax: 626-445-3341
Mailing address:
  • Phone: 626-332-3145
  • Fax: 626-453-3431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LYNETTA HALE
Title or Position: SENIOR DIRECTOR OF CLINICAL SERVICE
Credential: AMFT, LPT, MA
Phone: 626-332-3145