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General NPI Number Information
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NPI Number | 1164286688
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Entity Type | Organization
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Legal Business Name | THE LEMONADE HOUSE LLC
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Dates
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Enumeration Date | 02/07/2024
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 39402 COLONY UNION ST
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City | MURRIETA
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State | CA
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Zip | 92563-7327
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Country | US
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Telephone | 760-272-6816
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Fax |
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Provider Business Mailing Address
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Address Line | 3312 CORTE DEL CRUCE
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City | CARLSBAD
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State | CA
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Zip | 92009-9546
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Country | US
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Telephone | 760-272-6816
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | AMY KONOPKA
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Credential |
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Telephone | 760-272-6816
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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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