MEDICARE: THE GROVE RECOVERY COMMUNITY, 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	:	1659011625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE GROVE RECOVERY COMMUNITY, INC

Provider Business Mailing Address
First Line	:	2942 CENTURY PL # 716
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92626-4324
Country	:	US
Telephone Number	:	805-512-1694
Fax Number	:

Provider Business Practice Location Address
First Line	:	1560 BROOKHOLLOW DR STE 106
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92705-5428
Country	:	US
Telephone Number	:	312-315-3315
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	CHRISTOPHER M BRINEY
Credential	:
Telephone Number	:	805-512-1694

Provider Enumeration Date	:	03/29/2022
Last Update Date	:	06/10/2026

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