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General NPI Number Information
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NPI Number | 1447619077
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Entity Type | Organization
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Legal Business Name | THE BETHESDA RECOVERY CENTER
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Dates
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Enumeration Date | 02/10/2016
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Last Update Date | 10/27/2016
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Provider Practice Location Address
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Address Line | 733 S SANTA FE AVE
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City | VISTA
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State | CA
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Zip | 92083-5939
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Country | US
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Telephone | 760-945-5290
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Fax | 760-945-7765
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Provider Business Mailing Address
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Address Line | 733 S SANTA FE AVE
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City | VISTA
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State | CA
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Zip | 92083-5939
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Country | US
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Telephone | 760-945-5290
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Fax | 760-945-7765
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. ALICE BURGARD
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Credential |
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Telephone | 760-945-5290
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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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