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General NPI Number Information
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NPI Number | 1306113956
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Entity Type | Organization
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Legal Business Name | A BETTER CHOICE RECOVERY CENTER
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Dates
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Enumeration Date | 11/28/2011
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Last Update Date | 11/28/2011
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Provider Practice Location Address
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Address Line | 8011 CAVE CITY ROAD
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City | MOUNTAIN RANCH
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State | CA
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Zip | 95246
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Country | US
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Telephone | 209-754-0200
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Fax | 209-754-0210
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Provider Business Mailing Address
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Address Line | 8011 CAVE CITY RD.
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City | MOUNTAIN RANCH
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State | CA
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Zip | 95246
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Country | US
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Telephone | 209-754-0200
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Fax | 209-754-0210
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Authorized Official
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Title or Position | MARKETING DIRECTOR
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Name | MRS. LESLIE ELAINE RIDEOUT
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Credential | BA BUSINESS
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Telephone | 916-335-2401
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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 | 050004AP
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License Number State | CA
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