Organization
REFUGE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE M TERRY (BILLING MANAGER)
(909) 379-9237
Entity
Organization
Contact information
Practice address
1366 YELLOWSTONE DR, LAKE ARROWHEAD, CA 92352-1238
(909) 337-4224
(888) 509-3920
Mailing address
PO BOX 1238, 1366 YELLOWSTONE DR, LAKE ARROWHEAD, CA 92352-1238
(909) 337-4224
(888) 509-3920
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
360094AP
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
360094AP
CA LIC
CA
Enumeration date
07/15/2014
Last updated
07/15/2014
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