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General NPI Number Information
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NPI Number | 1104380047
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Entity Type | Organization
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Legal Business Name | OCEAN HILLS RECOVERY INC.
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Dates
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Enumeration Date | 01/24/2019
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Last Update Date | 01/24/2019
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Provider Practice Location Address
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Address Line | 34469 CAMINO EL MOLINO
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City | DANA POINT
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State | CA
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Zip | 92624-1070
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Country | US
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Telephone | 949-388-0112
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Fax | 949-388-4625
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Provider Business Mailing Address
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Address Line | 27124 PASEO ESPADA STE 805
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-6787
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Country | US
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Telephone | 949-388-0112
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Fax | 949-388-4625
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | HOLLY WAGNER
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Credential |
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Telephone | 949-388-0112
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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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