Organization
ABLE TO CHANGE RECOVERY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL O PASTOR (BILLING)
(949) 493-6800
Entity
Organization
Contact information
Practice address
31501 RANCHO VIEJO RD, #101, SAN JUAN CAPISTRANO, CA 92675-1869
(949) 493-6800
(949) 493-6832
Mailing address
31501 RANCHO VIEJO RD, #101, SAN JUAN CAPISTRANO, CA 92675-1869
(949) 493-6800
(949) 493-6832
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
300118AP
CA
324500000X
Substance Abuse Rehabilitation Facility
300118BP
CA
324500000X
Substance Abuse Rehabilitation Facility
300118CP
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005494
BLUE CROSS MED ID
CA
01
—
005692
BLUE CROSS MED ID
CA
01
—
005693
BLUE CROSS MED ID
CA
01
—
300118AP
CA DEPT ALCOHOL DRUG PROGRAMS
CA
01
—
300118BP
CA DEPT ALCOHOL DRUG PROGRAMS
CA
01
—
300118CP
CA DEPT ALCOHOL DRUG PROGRAMS
CA
Enumeration date
02/15/2007
Last updated
07/26/2019
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