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General NPI Number Information
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NPI Number | 1881142313
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Entity Type | Organization
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Legal Business Name | PILLARS RECOVERY, LLC
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Dates
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Enumeration Date | 09/13/2016
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Last Update Date | 09/13/2016
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Provider Practice Location Address
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Address Line | 28772 TOP OF THE WORLD DR
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-2071
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Country | US
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Telephone | 949-548-1500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 986
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City | CORONA DEL MAR
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State | CA
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Zip | 92625-5986
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Country | US
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Telephone | 949-548-1500
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | PETER M GATES
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Credential |
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Telephone | 949-548-1500
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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 | 300312BP
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License Number State | CA
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