MEDICARE: L.U.N.A. RECOVERY

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
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225344179
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	L.U.N.A. RECOVERY

Provider Business Mailing Address
First Line	:	6608 GRETNA AVE
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90606-1902
Country	:	US
Telephone Number	:	562-699-0400
Fax Number	:	562-699-0422

Provider Business Practice Location Address
First Line	:	12417 PHILADELPHIA ST
Second Line	:	LIBRARY
City	:	WHITTIER
State	:	CA
Zip	:	90601-3933
Country	:	US
Telephone Number	:	562-698-8721
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	RAMONA GARCIA
Credential	:
Telephone Number	:	562-699-0400

Provider Enumeration Date	:	08/28/2010
Last Update Date	:	08/28/2010

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Directions to “L.U.N.A. RECOVERY ” Practice Location

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