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General NPI Number Information
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NPI Number | 1982915807
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Entity Type | Organization
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Legal Business Name | ADELANTE RECOVERY CENTER, INC
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Dates
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Enumeration Date | 06/25/2010
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Last Update Date | 06/25/2010
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Provider Practice Location Address
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Address Line | 49 MONTECITO DR
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City | CORONA DEL MAR
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State | CA
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Zip | 92625-1017
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Country | US
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Telephone | 949-887-4448
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Fax | 949-706-9769
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Provider Business Mailing Address
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Address Line | PO BOX 604
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City | CORONA DEL MAR
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State | CA
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Zip | 92625-0604
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Country | US
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Telephone | 949-887-4448
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Fax | 949-706-9769
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Authorized Official
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Title or Position | MANAGER
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Name | DAN BASKEY
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Credential |
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Telephone | 949-887-4448
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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 | 300206AP
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License Number State | CA
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