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NPI Code Detail

MEDICARE: ORCHID RECOVERY CENTER

MEDICARE: ORCHID RECOVERY CENTER
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 Facility010006ANCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1010006ANOTHERCACALIFORNIA DEPT OF ALCOHO

General Provider Information

NPI Number : 1649456955
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORCHID RECOVERY CENTER
Provider Business Mailing Address
First Line : 1342 E 27TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94606-3266
Country : US
Telephone Number : 510-535-0611
Fax Number : 510-535-1358
Provider Business Practice Location Address
First Line : 1342 E 27TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94606-3266
Country : US
Telephone Number : 510-535-0611
Fax Number : 510-535-1358
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : SUSAN CINELLI
Credential :
Telephone Number : 925-798-7250
Provider Enumeration Date : 01/16/2008
Last Update Date : 01/16/2008

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Directions to “ORCHID RECOVERY CENTER ” Practice Location

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