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General NPI Number Information
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NPI Number | 1356890073
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Entity Type | Organization
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Legal Business Name | MORNINGSIDE RECOVERY, LLC
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Dates
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Enumeration Date | 09/22/2016
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Last Update Date | 09/22/2016
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Provider Practice Location Address
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Address Line | 9842 13TH ST
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City | GARDEN GROVE
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State | CA
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Zip | 92844-3171
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Country | US
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Telephone | 949-675-0006
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 REYNOLDS AVE STE 200
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City | IRVINE
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State | CA
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Zip | 92614-5559
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Country | US
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Telephone | 949-675-0006
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Fax | 949-675-0007
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Authorized Official
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Title or Position | OWNER
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Name | RAYMOND G YATES
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Credential |
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Telephone | 949-675-0006
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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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