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General NPI Number Information
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NPI Number | 1275001067
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Entity Type | Organization
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Legal Business Name | BRYAN'S HOUSE RECOVERY HOME
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Dates
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Enumeration Date | 11/09/2018
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 5655 ARDILLA AVE
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City | ATASCADERO
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State | CA
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Zip | 93422-3222
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Country | US
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Telephone | 805-460-6621
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Fax | 866-306-5825
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Provider Business Mailing Address
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Address Line | 7760 WHISPERING TRAILS PL
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City | PASO ROBLES
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State | CA
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Zip | 93446-6396
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Country | US
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Telephone | 805-674-3131
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Fax | 866-306-5825
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Authorized Official
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Title or Position | DIRECTOR
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Name | SANDRA LEA WORTLEY
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Credential | LAADC
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Telephone | 805-464-4660
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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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