Healthcare Provider Details

I. General information

NPI: 1801242763
Provider Name (Legal Business Name): RECOVERY HOMES OF AMERICA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2016
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 S YORBA ST
ORANGE CA
92869-4609
US

IV. Provider business mailing address

1950 E 17TH ST SUITE 150
SANTA ANA CA
92705-6852
US

V. Phone/Fax

Practice location:
  • Phone: 714-547-5375
  • Fax: 714-541-3320
Mailing address:
  • Phone: 714-547-5375
  • Fax: 714-541-3320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number300017FP
License Number StateCA

VIII. Authorized Official

Name: SAMANTHA STONE
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 714-547-5375