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General NPI Number Information
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NPI Number | 1134815822
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Entity Type | Organization
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Legal Business Name | HEALTHY LIFE RECOVERY INC.
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Dates
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Enumeration Date | 04/14/2023
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Last Update Date | 04/14/2023
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Provider Practice Location Address
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Address Line | 4320 TRIAS ST
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City | SAN DIEGO
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State | CA
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Zip | 92103-1127
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Country | US
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Telephone | 858-888-5332
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Fax | 858-300-5197
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Provider Business Mailing Address
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Address Line | 4629 CASS ST # 356
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City | SAN DIEGO
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State | CA
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Zip | 92109-2805
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Country | US
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Telephone | 858-888-5332
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | RYAN WITT
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Credential |
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Telephone | 858-888-5332
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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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