Healthcare Provider Details
I. General information
NPI: 1619248002
Provider Name (Legal Business Name): MFI RECOVERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/18/2012
Last Update Date: 04/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5870 ARLINGTON AVE SUITE 103
RIVERSIDE CA
92504-2037
US
IV. Provider business mailing address
31555 RANCHO VISTA RD
TEMECULA CA
92592-3516
US
V. Phone/Fax
- Phone: 951-683-6596
- Fax: 951-683-4239
- Phone: 951-683-6596
- Fax: 951-683-4239
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CRAIG
LAMBDIN
Title or Position: EXECUTIVE DIRECTOR
Credential: MA
Phone: 951-683-6596