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General NPI Number Information
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NPI Number | 1619422821
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Entity Type | Organization
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Legal Business Name | GET REAL RECOVERY INC.
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Dates
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Enumeration Date | 08/17/2016
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Last Update Date | 12/28/2023
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Provider Practice Location Address
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Address Line | 28334 PASEO MICHELLE
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-5523
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Country | US
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Telephone | 949-481-8152
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Fax |
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Provider Business Mailing Address
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Address Line | 30290 RANCHO VIEJO RD STE 204
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-1580
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Country | US
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Telephone | 949-481-8152
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Fax |
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Authorized Official
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Title or Position | OFFICE ADMIN
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Name | DAVID YOUNG
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Credential |
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Telephone | 310-343-8684
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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 | 300252BP
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License Number State | CA
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