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General NPI Number Information
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NPI Number | 1053138461
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Entity Type | Organization
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Legal Business Name | HOPE RANCH 211 LLC
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Dates
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Enumeration Date | 09/25/2024
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 25780 STATE HIGHWAY 74
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City | PERRIS
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State | CA
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Zip | 92570-8769
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Country | US
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Telephone | 949-800-9613
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Fax |
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Provider Business Mailing Address
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Address Line | 24046 CLINTON KEITH RD STE 101-185
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City | WILDOMAR
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State | CA
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Zip | 92595-8050
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MAGGIE SCOTTO
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Credential |
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Telephone | 949-800-9613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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