Healthcare Provider Details

I. General information

NPI: 1487410254
Provider Name (Legal Business Name): HUNTINGTON BEACH RECOVERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2024
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7761 GARFIELD AVE
HUNTINGTON BEACH CA
92648-2015
US

IV. Provider business mailing address

7761 GARFIELD AVE UNIT 101
HUNTINGTON BEACH CA
92648-2015
US

V. Phone/Fax

Practice location:
  • Phone: 310-279-3905
  • Fax:
Mailing address:
  • Phone: 949-701-1959
  • 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: PETER GATES
Title or Position: CONSULTANT
Credential:
Phone: 949-701-1959