Organization
EXECUTIVE RESIDENTIAL CARE & RECOVERY LLC
Active
Other names
SYNERGY ESTATE
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY MORA (ASSOC. DIRECTOR OF PATIENT ACCT)
(562) 576-1284
Entity
Organization
Contact information
Practice address
70806 HALPER LAKE DR, RANCHO MIRAGE, CA 92270-2523
(760) 832-8810
Mailing address
11627 TELEGRAPH RD STE 200, SANTA FE SPRINGS, CA 90670-6814
(562) 576-1284
(562) 861-0883
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/26/2022
Last updated
08/26/2022
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