Organization
PURE PATH RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AARON JENNINGS MBA (OWNER/CFO)
(949) 375-0070
Entity
Organization
Contact information
Practice address
51 SORBONNE ST, WESTMINSTER, CA 92683-8916
(949) 375-0070
(949) 429-7193
Mailing address
216 TECHNOLOGY DR, STE#A, IRVINE, CA 92618-2407
(949) 375-0070
(949) 429-7193
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
300663AP
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300663AP
LICENSE
CA
Enumeration date
08/31/2016
Last updated
08/31/2016
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