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General NPI Number Information
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NPI Number | 1922459551
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Entity Type | Organization
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Legal Business Name | TRUE LIFE RECOVERY, INC.
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Dates
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Enumeration Date | 06/24/2016
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 16832 MAPLE ST
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-2227
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Country | US
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Telephone | 949-520-0350
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3097
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City | NEWPORT BEACH
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State | CA
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Zip | 92659-0639
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Country | US
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Telephone | 949-520-0530
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Fax | 949-271-4871
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | HAYDEN MOSER
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Credential |
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Telephone | 949-446-6281
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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 | 300631AP
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License Number State | CA
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