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General NPI Number Information
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NPI Number | 1275217291
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Entity Type | Organization
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Legal Business Name | AURORA RECOVERY
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Dates
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Enumeration Date | 06/12/2023
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Last Update Date | 06/12/2023
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Provider Practice Location Address
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Address Line | 5035 AMESTOY AVE
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City | ENCINO
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State | CA
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Zip | 91316-3409
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Country | US
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Telephone | 661-331-7326
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Fax |
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Provider Business Mailing Address
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Address Line | 721 LA GRACIA
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City | SANTA MARIA
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State | CA
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Zip | 93455-1308
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Country | US
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Telephone | 661-331-7326
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SEAN NOLAN
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Credential |
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Telephone | 661-331-7326
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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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