Organization
LIFELINE RESIDENTIAL TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAXTON JACKSON CADCCAS-RAS (EXECUTIVE DIRECTOR)
(530) 282-4357
Entity
Organization
Contact information
Practice address
5075 LINCOLN BLVD, OROVILLE, CA 95966-6927
(530) 282-4357
(530) 282-4948
Mailing address
5075 LINCOLN BLVD, OROVILLE, CA 95966-6927
(530) 282-4357
(530) 282-4948
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
040032AP
CA
Other
Enumeration date
08/27/2015
Last updated
08/27/2015
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