Healthcare Provider Details

I. General information

NPI: 1053962688
Provider Name (Legal Business Name): SUCCESS IN RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2019
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3713 W HOWARD AVE
VISALIA CA
93277-4027
US

IV. Provider business mailing address

PO BOX 2556
VISALIA CA
93279-2556
US

V. Phone/Fax

Practice location:
  • Phone: 559-627-9848
  • Fax:
Mailing address:
  • Phone: 559-635-4780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: BRAD HARNESS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 559-635-4780