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General NPI Number Information
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NPI Number | 1376093237
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Entity Type | Organization
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Legal Business Name | SOUTHERN CALIFORNIA SUNRISE RECOVERY CENTER
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Dates
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Enumeration Date | 10/04/2016
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Last Update Date | 01/07/2021
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Provider Practice Location Address
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Address Line | 30471 VIA ALCAZAR AVE
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-2137
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Country | US
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Telephone | 949-388-3857
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Fax | 949-388-3857
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Provider Business Mailing Address
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Address Line | 28562 OSO PKWY # D-313
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-5595
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Country | US
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Telephone | 949-533-3046
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. USHA VILLAREAL
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Credential | RN
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Telephone | 949-533-4025
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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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