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General NPI Number Information
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NPI Number | 1508671751
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Entity Type | Organization
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Legal Business Name | 3D RECOVERY
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Dates
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Enumeration Date | 02/12/2025
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 5001 54TH ST
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City | SAN DIEGO
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State | CA
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Zip | 92115-2229
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Country | US
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Telephone | 619-928-7968
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Fax |
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Provider Business Mailing Address
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Address Line | 7714 UNIVERSITY AVE
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City | LA MESA
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State | CA
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Zip | 91942-4902
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Country | US
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Telephone | 619-928-7968
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. MARTIN HANA
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Credential |
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Telephone | 619-928-7968
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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 | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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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 #5
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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