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Organization
FRIENDLY RECOVERY CENTER, LLC
Active
Organization
FRIENDLY RECOVERY CENTER, LLC
Active
Other names
Friendly Recovery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID HAM MBA (CHIEF EXECUTIVE OFFICER)
(657) 218-9125
Entity
Organization
Contact information
Practice address
15991 RED HILL AVE STE 101, TUSTIN, CA 92780-7320
(657) 218-9125
(949) 781-4526
Mailing address
13681 NEWPORT AVE STE 8614, TUSTIN, CA 92780-4689
(657) 218-9125
(714) 455-7260
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
03/15/2024
Last updated
11/22/2024
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