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General NPI Number Information
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NPI Number | 1407710015
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Entity Type | Organization
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Legal Business Name | SAN DIEGO CENTER FOR RECOVERY LLC
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 4885 GREENCRAIG LN
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City | SAN DIEGO
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State | CA
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Zip | 92123-1664
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Country | US
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Telephone | 747-265-9704
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Fax |
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Provider Business Mailing Address
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Address Line | 2821 LANGE AVE
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City | SAN DIEGO
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State | CA
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Zip | 92122-3109
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | JOY CROWNOVER
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Credential |
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Telephone | 747-265-9704
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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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