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General NPI Number Information
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NPI Number | 1538654520
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Entity Type | Organization
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Legal Business Name | RANCHO MILAGRO RECOVERY INC
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Dates
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Enumeration Date | 06/22/2018
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Last Update Date | 07/26/2021
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Provider Practice Location Address
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Address Line | 37235 PAINTED PONY RD
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City | TEMECULA
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State | CA
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Zip | 92592-8221
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Country | US
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Telephone | 951-852-7674
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Fax |
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Provider Business Mailing Address
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Address Line | 37115 PAINTED PONY RD
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City | TEMECULA
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State | CA
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Zip | 92592-8262
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Country | US
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Telephone | 951-526-3227
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | JUDEE RAFFAEL TOMPKINS
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Credential |
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Telephone | 951-526-3227
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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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