Organization
RIDGEVIEW DRIVE RANCH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY THORNTON (AUTHORIZED OFFICIAL)
(626) 482-3478
Entity
Organization
Contact information
Practice address
741 W WOODBURY RD, ALTADENA, CA 91001
(800) 296-1868
Mailing address
3085 RIDGEVIEW DR, ALTADENA, CA 91001-4527
(800) 296-1868
(310) 836-4500
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190627GP
DHCS
CA
Enumeration date
01/22/2013
Last updated
06/21/2018
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