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Organization
CHILDREN'S RECOVERY CENTER 1, LLC
Active
Organization
CHILDREN'S RECOVERY CENTER 1, LLC
Active
Other names
Children's Recovery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH SHAWN MCGUIRE (PRESIDENT/CEO)
(408) 340-1568
Entity
Organization
Contact information
Practice address
3777 S. BASCOM AVE., CAMPBELL, CA 95008
(408) 340-1568
(408) 866-8144
Mailing address
3777 S. BASCOM AVE., CAMPBELL, CA 95008
(408) 340-1568
(408) 866-8144
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
070000320
CA
Other
Enumeration date
11/03/2006
Last updated
02/08/2017
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