Healthcare Provider Details
I. General information
NPI: 1710579099
Provider Name (Legal Business Name): COMPASSION RECOVERY CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/08/2021
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23141 MOULTON PKWY STE 207
LAGUNA HILLS CA
92653-1204
US
IV. Provider business mailing address
23141 MOULTON PKWY STE 207
LAGUNA HILLS CA
92653-1204
US
V. Phone/Fax
- Phone: 877-414-3007
- Fax:
- Phone: 877-414-3007
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 324500000X |
| Taxonomy | Substance Abuse Rehabilitation Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSHUA
EUGENE
MARQUEZ
Title or Position: CEO
Credential:
Phone: 877-414-3007