# MOUNTAIN HIGH RECOVERY CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033805015
- **Authorized official:** KIM HEWETT (ADMINISTRATIVE ASSISTANT)
- **Authorized official phone:** (918) 207-9519

## Contact information

- **Practice address:** 2949 LAKE TAHOE BLVD, SUITE B7, SOUTH LAKE TAHOE, CA 96150
- **Practice address phone:** (530) 600-6505
- **Mailing address:** 2949 LAKE TAHOE BLVD, SUITE B7, SOUTH LAKE TAHOE, CA 96150
- **Mailing address phone:** (530) 600-6505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 04/13/2023
- **Last updated:** 04/13/2023