MEDICARE: ZAKS HOUSE INC.

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	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1275126088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZAKS HOUSE INC.

Provider Business Mailing Address
First Line	:	1419 WINTER HAVEN RD
Second Line	:
City	:	FALLBROOK
State	:	CA
Zip	:	92028-4606
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1419 WINTER HAVEN RD
Second Line	:
City	:	FALLBROOK
State	:	CA
Zip	:	92028-4606
Country	:	US
Telephone Number	:	312-315-3315
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	IAN ROY
Credential	:
Telephone Number	:	949-446-6288

Provider Enumeration Date	:	02/12/2021
Last Update Date	:	01/18/2022

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Directions to “ZAKS HOUSE INC. ” Practice Location

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