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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