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General NPI Number Information
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NPI Number | 1871930966
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Entity Type | Organization
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Legal Business Name | CACTUS GARDENS OPPORTUNITY HOUSE, INC
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Dates
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Enumeration Date | 05/29/2013
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Last Update Date | 06/13/2023
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Provider Practice Location Address
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Address Line | 13212 CHAPMAN AVE
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City | GARDEN GROVE
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State | CA
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Zip | 92840-4414
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Country | US
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Telephone | 714-703-9492
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Fax | 714-740-2030
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Provider Business Mailing Address
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Address Line | 19311 SAUSALITO LN
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-2648
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Country | US
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Telephone | 714-369-3381
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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 | STANLEY CLAUDE WOOLBRIGHT
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Credential |
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Telephone | 714-369-3381
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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 | 300292AN
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License Number State | CA
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