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NPI Code Detail

MEDICARE: THE RECOVERY VILLAGE CALIFORNIA, LLC

MEDICARE: THE RECOVERY VILLAGE CALIFORNIA, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1205605540
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE RECOVERY VILLAGE CALIFORNIA, LLC
Provider Business Mailing Address
First Line : 2200 N COMMERCE PKWY STE 200
Second Line :
City : WESTON
State : FL
Zip : 33326-3258
Country : US
Telephone Number : 754-300-3120
Fax Number : 888-919-4431
Provider Business Practice Location Address
First Line : 43700 CACTUS VALLEY RD
Second Line :
City : HEMET
State : CA
Zip : 92544-9337
Country : US
Telephone Number : 305-785-5520
Fax Number : 888-919-4431
Authorized Official
Title or Position : CONTRACTING & LICENSING DIRECTOR
Name : BELINA SURUJON
Credential :
Telephone Number : 305-785-5520
Provider Enumeration Date : 12/28/2023
Last Update Date : 05/11/2026

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Directions to “THE RECOVERY VILLAGE CALIFORNIA, LLC ” Practice Location

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