MEDICARE: ALTITUDE RECOVERY COMMUNITY NO 2

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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
2	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1982337101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTITUDE RECOVERY COMMUNITY NO 2

Provider Business Mailing Address
First Line	:	2511 WORTH WAY
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93012-9087
Country	:	US
Telephone Number	:	661-600-5245
Fax Number	:

Provider Business Practice Location Address
First Line	:	2511 WORTH WAY
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93012-9087
Country	:	US
Telephone Number	:	661-600-5245
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	KIMBERLY NEUHALFEN
Credential	:
Telephone Number	:	805-427-0404

Provider Enumeration Date	:	07/06/2022
Last Update Date	:	11/26/2025

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