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Organization
IMPACT RECOVERY
Active
Organization
IMPACT RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY BUELL CMRS (BILLING MANAGER)
(949) 842-2877
Entity
Organization
Contact information
Practice address
28202 CABOT ROAD, SUITE 331, LAGUNA NIGUEL, CA 92677-1222
(714) 398-5874
(949) 248-2870
Mailing address
PO BOX 1449, SAN JUAN CAPISTRANO, CA 92693-1449
(949) 842-2877
(949) 248-2870
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
09/25/2018
Last updated
02/11/2022
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