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General NPI Number Information
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NPI Number | 1518401249
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Entity Type | Organization
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Legal Business Name | BELGRAVE RECOVERY CENTER
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Dates
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Enumeration Date | 12/14/2016
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | 2668 BELGRAVE AVE
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-2934
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Country | US
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Telephone | 310-270-1195
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Fax |
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Provider Business Mailing Address
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Address Line | 202 E COMMONWEALTH AVE # 565
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City | FULLERTON
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State | CA
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Zip | 92836-8600
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Country | US
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Telephone | 310-270-1195
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. CARLOS SANCHEZ
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Credential |
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Telephone | 310-270-1195
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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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