Healthcare Provider Details

I. General information

NPI: 1134622749
Provider Name (Legal Business Name): LAKE HUGHES RECOVERY O P, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2018
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49713B GORMAN POST RD
GORMAN CA
93243-9701
US

IV. Provider business mailing address

28765 PINE CANYON RD
LAKE HUGHES CA
93532-1046
US

V. Phone/Fax

Practice location:
  • Phone: 661-724-0001
  • Fax: 661-481-3392
Mailing address:
  • Phone: 661-724-0001
  • Fax: 661-482-3392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ALEXANDER FRANKIAN
Title or Position: CEO
Credential:
Phone: 661-724-0001