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General NPI Number Information
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NPI Number | 1598151490
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Entity Type | Organization
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Legal Business Name | ZEN MOUNTAIN PATH
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 04/08/2015
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Provider Practice Location Address
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Address Line | 9 JETTY DR
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City | CORONA DEL MAR
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State | CA
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Zip | 92625-1425
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Country | US
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Telephone | 800-759-1930
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Fax |
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Provider Business Mailing Address
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Address Line | 9 JETTY DR
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City | CORONA DEL MAR
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State | CA
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Zip | 92625-1425
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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 | CEO
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Name | HELEN CARVER
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Credential |
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Telephone | 312-617-8411
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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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