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General NPI Number Information
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NPI Number | 1831908276
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Entity Type | Organization
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Legal Business Name | RUSTLERS REAL ESTATE LLC
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Dates
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Enumeration Date | 12/31/2024
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 18023 SKY PARK CIR STE F
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City | IRVINE
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State | CA
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Zip | 92614-6550
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Country | US
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Telephone | 714-352-9138
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Fax |
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Provider Business Mailing Address
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Address Line | 20500 BELSHAW AVE. DPT#XLA1130
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City | CARSON
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State | CA
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Zip | 90746
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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 | VP OF CORPORATE DEVELOPMENT & GENER
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Name | AARON BAILEY
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Credential |
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Telephone | 714-352-9138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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