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General NPI Number Information
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NPI Number | 1649456955
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Entity Type | Organization
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Legal Business Name | ORCHID RECOVERY CENTER
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Dates
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Enumeration Date | 01/16/2008
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Last Update Date | 01/16/2008
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Provider Practice Location Address
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Address Line | 1342 E 27TH ST
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City | OAKLAND
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State | CA
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Zip | 94606-3266
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Country | US
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Telephone | 510-535-0611
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Fax | 510-535-1358
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Provider Business Mailing Address
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Address Line | 1342 E 27TH ST
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City | OAKLAND
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State | CA
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Zip | 94606-3266
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Country | US
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Telephone | 510-535-0611
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Fax | 510-535-1358
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | SUSAN CINELLI
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Credential |
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Telephone | 925-798-7250
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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 | 010006AN
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License Number State | CA
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