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General NPI Number Information
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NPI Number | 1467200253
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Entity Type | Organization
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Legal Business Name | CLEAN PATH RECOVERY
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Dates
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Enumeration Date | 05/08/2024
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 11651 JERRY LN
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City | GARDEN GROVE
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State | CA
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Zip | 92840-3515
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Country | US
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Telephone | 949-734-7432
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3211
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City | NEWPORT BEACH
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State | CA
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Zip | 92659-0855
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Country | US
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Telephone | 949-278-1915
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LEE HEILIGMAN
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Credential |
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Telephone | 949-278-1915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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