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General NPI Number Information
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NPI Number | 1578037271
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Entity Type | Organization
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Legal Business Name | RESILIENCE REHABILITATION, LLC
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Dates
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Enumeration Date | 01/15/2019
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Last Update Date | 10/16/2019
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Provider Practice Location Address
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Address Line | 25207 PARKCREST DR
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City | MURRIETA
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State | CA
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Zip | 92562-5950
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Country | US
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Telephone | 562-841-2537
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Fax |
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Provider Business Mailing Address
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Address Line | 25207 PARKCREST DR
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City | MURRIETA
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State | CA
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Zip | 92562-5950
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | HUA MA CORDINGLY
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Credential |
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Telephone | 888-772-5191
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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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